Inflammatory demyelinating pseudotumor usually occurs in the brain and rarely occurs in the spinal cord. On imaging, inflammatory demyelinating pseudotumor appears very similar to intramedullary tumors such as gliomas...Inflammatory demyelinating pseudotumor usually occurs in the brain and rarely occurs in the spinal cord. On imaging, inflammatory demyelinating pseudotumor appears very similar to intramedullary tumors such as gliomas. It is often misdiagnosed as intramedullary tumor and surgically resected. In view of this, the clinical and magnetic resonance imaging manifestations and the pathological fea- tures of 36 cases of inflammatory demyelinating pseudotumer in the spinal cord were retrospec- tively analyzed and summarized. Most of these cases suffered from acute or subacute onset and exhibited a sensofimotor disorder. Among them, six cases were misdiagnosed as having intrame- dullary gliomas, and inflammatory demyelinating pseudotumor was only identified and pathologically confirmed after surgical resection. Lesions in the cervical and thoracic spinal cord were common. Magnetic resonance imaging revealed edema and space-occupying lesions to varying degrees at the cervical-thoracic junction, with a predominant feature of non-closed rosette-like reinforcement （open-loop sign）. Pathological examination showed perivascular cuffing of predominantly dense lymphocytes, and demyelination was observed in six of the misdiagnosed cases. These re- sults suggest that tumor-like inflammatory demyelinating disease in the spinal cord is a kind of special demyelinating disease that can be categorized as inflammatory pseudotumor. These solitary lesions are easily confused with intramedullary neoplasms. Patchy or non-closed reinforcement （open-ring sign） on magnetic resonance imaging is the predominant property of inflammatory de- myelinating pseudotumor, and inflammatory cell infiltration and demyelination are additional patho- logical properties.展开更多
Intramedullary spinal cord metastasis(ISCM) is very rare and its optimal treatment remains controversial. Pancreatic neuroendocrine tumor(pNET) is a rare tumor that usually presents with hepatic metastasis. Hepatic fa...Intramedullary spinal cord metastasis(ISCM) is very rare and its optimal treatment remains controversial. Pancreatic neuroendocrine tumor(pNET) is a rare tumor that usually presents with hepatic metastasis. Hepatic failure due to tumor progression is the major cause of death in cases of pNET. To date,no report has described a case of ISCM from pNET. Although spinal cord metastasis of a solid tumor is uncommon,it is a critical condition that can cause a potentially irreversible loss of neurologic function. Here,we report the case of a 45-year-old man who presented with leg weakness and voiding difficulty,and was found to have ISCM from pNET. Surgical treatment prevented further neurological deterioration. This is the first case report of ISCM from pNET.展开更多
目的:探讨肺癌脊柱转移瘤的手术治疗疗效和预后影响因素。方法:对2005年4月至2012年4月在北京大学第三医院骨科住院治疗且病理诊断明确的35例肺癌脊柱转移瘤患者的临床资料进行回顾性分析。根据治疗方法不同分为手术治疗组和保守治疗组...目的:探讨肺癌脊柱转移瘤的手术治疗疗效和预后影响因素。方法:对2005年4月至2012年4月在北京大学第三医院骨科住院治疗且病理诊断明确的35例肺癌脊柱转移瘤患者的临床资料进行回顾性分析。根据治疗方法不同分为手术治疗组和保守治疗组,比较手术组患者手术前后的疼痛程度、生活质量及神经功能状态;分析患者的生存期与放射治疗、内科治疗(化学治疗和/或靶向治疗)、手术治疗、神经功能状态和生活质量的关系。结果:28例(80%,28/35)获得随访资料,手术组22例,保守组6例。手术组疼痛程度和生活质量明显改善:视觉疼痛评分(visual analog scale,VAS)的中位数从术前的7分下降至术后3分(z=4.143,P<0.05),Karnorfsky日常状态评分的中位数从术前的50分上升至术后60分(z=3.825,P<0.05)。手术组有13例伴神经功能损害的患者术后神经功能明显改善(z=2.530,P<0.05)。生存分析结果显示内科治疗对肺癌脊柱转移瘤患者的生存期有显著影响(P=0.001),手术治疗、放射治疗、神经功能状态和生活质量对生存期无明显影响。结论:手术治疗肺癌脊柱转移瘤能有效缓解患者的疼痛程度,提高生活质量,改善神经功能;影响肺癌脊柱转移瘤患者生存期的主要因素是内科治疗。展开更多
文摘Inflammatory demyelinating pseudotumor usually occurs in the brain and rarely occurs in the spinal cord. On imaging, inflammatory demyelinating pseudotumor appears very similar to intramedullary tumors such as gliomas. It is often misdiagnosed as intramedullary tumor and surgically resected. In view of this, the clinical and magnetic resonance imaging manifestations and the pathological fea- tures of 36 cases of inflammatory demyelinating pseudotumer in the spinal cord were retrospec- tively analyzed and summarized. Most of these cases suffered from acute or subacute onset and exhibited a sensofimotor disorder. Among them, six cases were misdiagnosed as having intrame- dullary gliomas, and inflammatory demyelinating pseudotumor was only identified and pathologically confirmed after surgical resection. Lesions in the cervical and thoracic spinal cord were common. Magnetic resonance imaging revealed edema and space-occupying lesions to varying degrees at the cervical-thoracic junction, with a predominant feature of non-closed rosette-like reinforcement （open-loop sign）. Pathological examination showed perivascular cuffing of predominantly dense lymphocytes, and demyelination was observed in six of the misdiagnosed cases. These re- sults suggest that tumor-like inflammatory demyelinating disease in the spinal cord is a kind of special demyelinating disease that can be categorized as inflammatory pseudotumor. These solitary lesions are easily confused with intramedullary neoplasms. Patchy or non-closed reinforcement （open-ring sign） on magnetic resonance imaging is the predominant property of inflammatory de- myelinating pseudotumor, and inflammatory cell infiltration and demyelination are additional patho- logical properties.
基金Supported by Grant from Gachon University Gil Medical Center,No.2013-37
文摘Intramedullary spinal cord metastasis(ISCM) is very rare and its optimal treatment remains controversial. Pancreatic neuroendocrine tumor(pNET) is a rare tumor that usually presents with hepatic metastasis. Hepatic failure due to tumor progression is the major cause of death in cases of pNET. To date,no report has described a case of ISCM from pNET. Although spinal cord metastasis of a solid tumor is uncommon,it is a critical condition that can cause a potentially irreversible loss of neurologic function. Here,we report the case of a 45-year-old man who presented with leg weakness and voiding difficulty,and was found to have ISCM from pNET. Surgical treatment prevented further neurological deterioration. This is the first case report of ISCM from pNET.
文摘目的:探讨肺癌脊柱转移瘤的手术治疗疗效和预后影响因素。方法:对2005年4月至2012年4月在北京大学第三医院骨科住院治疗且病理诊断明确的35例肺癌脊柱转移瘤患者的临床资料进行回顾性分析。根据治疗方法不同分为手术治疗组和保守治疗组,比较手术组患者手术前后的疼痛程度、生活质量及神经功能状态;分析患者的生存期与放射治疗、内科治疗(化学治疗和/或靶向治疗)、手术治疗、神经功能状态和生活质量的关系。结果:28例(80%,28/35)获得随访资料,手术组22例,保守组6例。手术组疼痛程度和生活质量明显改善:视觉疼痛评分(visual analog scale,VAS)的中位数从术前的7分下降至术后3分(z=4.143,P<0.05),Karnorfsky日常状态评分的中位数从术前的50分上升至术后60分(z=3.825,P<0.05)。手术组有13例伴神经功能损害的患者术后神经功能明显改善(z=2.530,P<0.05)。生存分析结果显示内科治疗对肺癌脊柱转移瘤患者的生存期有显著影响(P=0.001),手术治疗、放射治疗、神经功能状态和生活质量对生存期无明显影响。结论:手术治疗肺癌脊柱转移瘤能有效缓解患者的疼痛程度,提高生活质量,改善神经功能;影响肺癌脊柱转移瘤患者生存期的主要因素是内科治疗。
