颈椎骨巨细胞瘤复发翻修一例  

Revision following the recurrence of the giant cell tumor in the cervical vertebra: 1 case report

作　　者：王文达[1] 阮文枫 刘辉[1] 平安松[1] 

机构地区：[1]武汉大学中南医院骨科,430071

出　　处：《中国骨与关节杂志》2016年第1期74-76,共3页Chinese Journal of Bone and Joint

摘　　要：1940年,Jaffe[1]首次报道了骨巨细胞瘤（giant cell tumor,GCT）。GCT是一种常见于长骨干骺端的低度恶性肿瘤,多发生于20~40岁的女性患者[2]。脊柱GCT相对少见,约占脊柱原发肿瘤的1.4%~9.4%[3],好发于胸腰椎和骶尾骨[4],而颈椎GCT则更为罕见。近期我院收治1例颈椎GCT复发的患者,报告如下。临床资料患者,女,34岁,2014年5月因＂颈肩部疼痛1年余,加重伴左手麻木7天＂入院。查体：颈椎压痛（约C3~5棘突）。左颈肩及左上肢感觉略有减退,左臂偶有隐痛,左手拇指及食指麻木。病理征未引出。外院CT、MRI示C5椎体病理性骨折（图1a^d）。Objective To report a revision case following the recurrence of the giant cell tumor（ GCT） in the cervical vertebra. Methods A female patient（ 34 years old） had complained with neck-shoulder pain for more than one year and aggravated left hand numbness for 7 days. Physical examination： cervical tenderness, left shoulder and upper limb hypaesthesia, left thumb and index finger numbness. Pathologic reflex had not been drawn out. CT and MRI showed C5 pathological fracture. An anterior spine subtotal corpectomy of C5 and fusion with titanium mesh were conducted under general anesthesia. Pathological results showed GCT. After the surgery, the patient complained with left arm pain, right hand pain and numbness, waist and abdomen numbness, right lower limb weakness, and walking instability. So she was admitted to hospital again. Physical examination： double upper limbs＇ and right lower limb＇s muscle weakness, Hoffmann sign（ ＋）, Babinski sign（ ＋）. CT and MRI showed soft tissue signals in the left of C5, indicating GCT recurrence. An anterior and posterior C5 titanium mesh removal and reconstruction, left laminectomy, tumor resection with screw rod system and internal fixation were conducted under general anesthesia. ResultsPathological results showed GCT. The patient＇s two legs felt good, but numbness and hypaesthesia still existed in hands. The patient was transfered to oncology department for radiotherapy. Conclusions GCT in cervical vertebra is a kind of rare invasive tumor in clinic. Anterior and posterior staging operation is safe and effective.

关 键 词：颈椎 骨巨细胞瘤 复发 病例报告 

分 类 号：R738.1[医药卫生—肿瘤]