腰1椎管内异位汗腺导管扩张1例报告

A Case Report of Ectopic Sweat Duct Ectasia of Conus Medullaris

患者,女性,52岁,因'腰痛10^+d'入院。神经功能检查未见明显异常。术前影像学MRI检查见:腰椎1椎体层面椎管内硬膜下类圆形占位病变,大小约1.0 cm×0.8 cm×0.5 cm,边界较清晰,相邻马尾神经受压明显,病变在T1表现为稍高信号,T2表现为不均匀低信号,部分区域见稍高信号,增强示病变不均匀环形强化。入院后诊断为'腰1椎管内占位'。择期在全麻下行半椎板入路椎管内病变切除+神经根粘连松解术,术后病理检查显示病变为良性病变,囊壁内衬双层上皮细胞,周围平滑肌环绕。其上皮免疫表型为:广谱细胞角蛋白(PCK)(+)、人类上皮膜抗原(EMA)(+)、抗癌基因蛋白(P63)(+)、基底细胞角蛋白(CK5/6)(+)、囊肿病变液体蛋白-15(GCDFP15)(-),考虑异位汗腺导管扩张所致病变。术后诊断修正为'腰1椎管内异位汗腺导管扩张'。术后患者腰痛消失,无其他不适。随访患者恢复良好,复查MRI未见特殊异常。椎管内异位汗腺导致扩张十分罕见,目前国内外均未见相关报道。

A healthy 52-year-old woman presented with 10-days history of back pain.Neurologic testing failed to detect any functional deficits in the upper and lower extremities,and the patient had a full range of cervical spine motion without associated pain.Spinal CT and MRI revealed a well-circumscribed intradural mass located at conus medullaris.The operation of L1 hemilaminectomy was performed,and pathological examination discovered dilatation of sweat ducts and suggested the diagnosis of ectopic sweat duct ectasia.IHC staining in epithelia immunophenotype showed:pan-cytokeratin(PCK)(+),epithelia membrane antigen(EMA)(+),P63(+),cytokeratin 5/6(CK5/6)(+),gross cystic disease fluid protein 15(GCDFP15)(-).Intraspinal ectopic sweat duct ectasia is extremely rare,which has not been reported in the literature to date.