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Abstract：
Sinonasal undifferentiated carcinoma (SNUC) is a rare and aggressive cancer of the sinonasal tract and is often characterized by intracranial invasion. However, SNUC rarely metastasizes to the spine. In this paper, we present a case of extradural metastasis and invasion of the adjacent spine by SNUC. A 42-year-old man presented to our hospital with two-month history of anosmia and nosebleeds. Imaging studies showed a neoplasm of the ethmoid sinus with extension into the anterior cranial fossa. The patient underwent resection of the carcinoma and began chemoradiotherapy. After completing chemoradiotherapy the patient complained of neck pain radiating down the right arm, and imaging showed an extradural mass at the C5 vertebral level. The patient underwent laminectomy for debulking of this tumor. One month later, the patient complained of recurrent weakness and pain in the right shoulder and arm. Imaging showed an extradural tumor wrapping around the C7 and C8 nerve roots, as well as a separate tumor at C2 adherent to the dura. The extradural tumor at C2 was surgically resected. Further imaging showed multiple new soft tissue masses at the thoracic level. We present a case of SNUC metastasis to the extradural spine representing the second case reported in the literature. Peri-dural metastasis and resulting symptoms should be included in the differential diagnosis and assessment of patients with SNUC.
摘要：
鼻窦未分化癌（SNUC）是一种罕见的侵袭性鼻腔鼻窦癌，通常以颅内浸润为特征。然而,SNUC很少转移到脊柱。在本文中,我们介绍了一例硬膜外转移和SNUC侵犯相邻脊柱的病例。一名42岁的男子到我们医院就诊，有两个月的失语症和流鼻血史。影像学研究显示筛窦肿瘤延伸到前颅窝。患者接受了癌切除术并开始放化疗。在完成放化疗后，患者抱怨颈部疼痛放射到右臂，影像学显示C5椎体有硬膜外肿块。患者接受了椎板切除术以消除该肿瘤。一个月后,患者主诉右肩和右臂反复出现无力和疼痛。影像学显示硬膜外肿瘤包裹在C7和C8神经根周围，以及与硬膜粘附的C2处的单独肿瘤。手术切除C2处的硬膜外肿瘤。进一步的成像显示胸部有多个新的软组织肿块。我们介绍了SNUC向硬膜外脊柱转移的病例，这是文献中报道的第二例。SNUC患者的鉴别诊断和评估应包括硬膜周围转移和由此产生的症状。
