PDF(Pubmed)
Abstract：
When a malignant tumor infiltrates the psoas muscle, it is termed malignant psoas syndrome (MPS). We are reporting this case because the malignancy led to atrophy of the psoas muscle, and the clinical course differed from the typical presentation of MPS. A 72-year-old Japanese female with advanced sigmoid colon cancer and multiple metastases had been undergoing systemic chemotherapy for four years. She complained of severe back pain on a numeric rating scale (NRS) of 4-5, left groin pain, and hip flexion weakness. Although she could stand up, she started experiencing difficulties while walking and became reliant on a wheelchair. At the time of referral to our department, her performance status was 2. On examination, she was capable of hip adduction and abduction, and flexion was impossible on the left side and possible on the right side. Imaging revealed metastases to the 11th and 12th thoracic vertebrae, extending to the upper portion of the first lumbar vertebra, leading to atrophy of the left psoas major muscle and impairment of hip flexion. She received palliative radiation therapy (RT) of 30 Gy in 10 fractions over a period of 2 weeks. Following RT, she had grade 1 skin inflammation but no severe complications. Two weeks after RT, her pain improved (NRS 0-1) and she regained hip flexion. When hip flexion failure occurs in patients with malignant tumors, it is important to recognize that it may be caused by a tumor located near the lower thoracic or upper lumbar spine, even if the psoas muscle itself is not directly infiltrated by the tumor.
摘要：
当恶性肿瘤浸润腰大肌时，它被称为恶性腰大肌综合征（MPS）。我们报告这个病例是因为恶性肿瘤导致腰大肌萎缩,临床病程与MPS的典型表现不同。一名72岁的日本女性患有晚期乙状结肠癌和多发性转移，已经接受了四年的全身化疗。她在4-5的数字评分（NRS）上抱怨严重的背痛，左腹股沟疼痛，和髋部屈曲无力。虽然她能站起来,她开始在行走时遇到困难，并开始依赖轮椅。在转诊到我们部门的时候，她的表现状态是2。在检查中，她有髋关节内收和绑架的能力,弯曲在左侧是不可能的，在右侧是可能的。影像学显示第11和12胸椎转移，延伸到第一腰椎的上部，导致左腰大肌萎缩和髋关节屈曲受损。她在2周的时间内接受了10分的30Gy姑息性放射治疗（RT）。在RT之后,患者有1级皮肤炎症,但无严重并发症.RT后两周，疼痛改善(NRS0-1),髋关节屈曲恢复.当恶性肿瘤患者发生髋关节屈曲失败时，重要的是要认识到它可能是由位于下胸椎或上腰椎附近的肿瘤引起的，即使腰大肌本身没有被肿瘤直接浸润。
