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題名 | 全脊髓內星狀細胞瘤併發延髓及脊髓空洞症:解剖研究報告 |
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作者 | 蘇泉發; | 書刊名 | 中華民國外科醫學會雜誌 |
卷期 | 18:1 1985.03[民74.03] |
頁次 | 頁56-62 |
分類號 | 416.292 |
關鍵詞 | 全脊髓內星狀細胞瘤; 延髓; 脊髓空洞症; |
語文 | 中文(Chinese) |
中文摘要 | 脊髓內星狀細胞瘤為少見之脊椎內腫瘤,若腫瘤向主向下形成囊腫,則不僅少見,且難與水性脊髓空洞症(syringohydromyelia)鑑別。本文報告-頸髓第2度星狀細胞瘤病例,產生廣泛延髓及胸髓囊腫,經一列檢查及解剖研究,發現腫瘤僅居頸髓部,上下延伸之空洞囊腫並無腫瘤細胞。據此研究及相關文獻之回顧,吾人建議對全脊髓內星狀細胞瘤之手術治療,僅須摘除腫瘤之實質部分上下引流囊腫內液體,而不必施行廣泛的椎板切除術來處理延伸之囊腫。 |
英文摘要 | Intramedullary astrocytoma is not frequently encountered among the intraspinal tumors. It occasionally can be a fluid-producing tumor with cysts extending in the whole spinal cord. This kind oftumor is difficult to be differentiated from syringohydromyelia that the syrinx communicates with the 4th ventricle. This article reported a 35-year-old female presenting central cord syndrome from the level of medulIa to the fifth thoracic level. The iopamidol (water-soluble contrast medium) lumbar myelography with CT scan study and C1-2 percutaneous cord cyst puncture with injection of iopamidol were performed. They revealed an intrameduallary tumor located at the cervical cord with caudal and rostral cystic formations. Unfortunately, the patient expired due to aspiration pneumonia caused by the neurological dysfunction of lower cranial nerves. The autopsy study revealed intramedullary astrocytoma located at the levels, C1 to C7. Two cysts located above and below this tumor involved the long segments of spinal cord. It extended to the junction of pons and medulla rostrally and to the eighth thoracic region caudally. Microscopically, this is an astrocytoma, grade II, with extending cysts that were surrounded by the gliotic tissue only. According to the anatomical findings and the reports of related papers, the article suggest that such a holocord astrocytoma should be operated on at the level of solid tumor only and drain the cysts above and below. Extensive laminectomy for removal of the extending cysts is unnecessary. |
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