宫颈癌椎管内硬脊膜外腔转移1例报告及文献复习  

Cervical cancer with intraspinal epidural space metastasis:A case report and literature review

作　　者：易亮 杨云梅[1] YI Liang;YANG Yunmei(Department of Geriatrics,First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,Zhejiang Povince,China)

机构地区：[1]浙江大学医学院附属第一医院干部病房,浙江杭州310003

出　　处：《肿瘤》2020年第2期133-136,共4页Tumor

摘　　要：目的:通过介绍1例宫颈癌伴椎管内硬脊膜外腔转移患者的诊治过程,增强临床医生对晚期宫颈癌转移的进一步认识。方法:报道1例中年女性宫颈癌晚期伴多发转移的患者,分析其诊治过程,并总结相关文献。结果:1名41岁女性,2019年7月因"双下肢无力伴麻木1周"入院。既往宫颈癌病史4年余。结合患者病史及脊柱胸腰段MR平扫+增强检查结果,考虑T5~7椎体水平椎管内病变为转移瘤可能。为改善患者症状,予以姑息手术治疗,术后椎管内肿瘤病理诊断证实为宫颈癌转移。术后1个月患者双下肢肌力较前好转,但2019年12月患者因肿瘤晚期多器官功能衰竭而死亡。结论:宫颈癌晚期常常发生血道转移,但椎管内硬脊膜外腔转移极为罕见,且预后差。因此,对于有宫颈癌病史且伴神经系统症状的患者,应高度怀疑宫颈癌伴脑或椎管内硬脊膜外腔转移可能。Objective:To introduce the diagnosis and treatment of a patient suffering from cervical cancer with intraspinal epidural space metastasis,aiming to provide the further insight into the metastasis of advanced cervical cancer for clinicians.Methods:A middle-aged female patient with multiple metastasis of advanced cervical cancer was reported.The diagnosis and treatment process of this case was analyzed,and the related literatures were reviewed.Results:A 41 years old female was admitted to the hospital in July2019 owing to the acratia and numbness of double lower limbs for1 week.Moreover,the patient suffered from cervical cancer and had been operated for more than 4 years.According to her medical history and the test of contrast-enhanced MR of thoracolumbar segment,the lesion located in the intraspinal epidural space on the height of T5-7 vertebral body was considered to be metastatic cancer.To alleviate the symptom,the patient received the palliative operation.The mass obtained from the intraspinal epidural space by operation was pathologically confirmed as the cervical cancer metastasis.The myodynamia of double lower limbs increased 1 month after operation.However,the patient died from multiple organ failure due to advanced cancer in December 2019.Conclusion:The advanced cervical cancer generally invades the organs by hematogenous metastasis,but the intraspinal epidural metastasis is very rare and the prognosis is very poor.Therefore,it should be highly suspected that cervival cancer may be accompanied by brain or intraspinal epidural metastasis if the patient has cervical cancer history and the symptoms of nerve system.

关 键 词：宫颈肿瘤 肿瘤转移 预后 椎管内硬脊膜外腔 

分 类 号：R737.33[医药卫生—肿瘤]