Abstract:
A 72-year-old female presented with 2 years of pro-gradient pain in the upper thoracic spine radiating to the left arm and leg. MRI revealed a 2.7 × 2.0 × 12 cm paravertebral mass at T2/T3, extending into the foraminal and epidural nerves with extensive dural sac contact in the left hemithorax. The removed tumour was surprisingly soft for a schwannoma or chordoma. However, after the surgery, histopathology revealed the presence of brachyury protein (T-box transcription factor T), which is characteristic of a chordoma. While chordomas are extremely rare, it is important that they are kept in mind for the differential diagnosis of a posterior mediastinal mass. Successful treatment can only be achieved through a complete en bloc resection. This can often be complex due to their location along the spine. This case report aims to highlight the features and treatment of this rare disease.
摘要:
一名72岁的女性表现为上胸椎向左臂和腿放射2年的前梯度疼痛。MRI显示T2/T3处有2.7×2.0×12cm的椎旁肿块,延伸到椎间孔和硬膜外神经,并在左半胸中有广泛的硬膜囊接触。对于神经鞘瘤或脊索瘤,切除的肿瘤令人惊讶地柔软。然而,手术后,组织病理学显示存在短尾蛋白(T-box转录因子T),这是脊索瘤的特征。虽然脊索瘤极为罕见,对于后纵隔肿块的鉴别诊断,记住它们是很重要的。成功的治疗只能通过完整的整体切除来实现。由于它们沿着脊柱的位置,这通常是复杂的。此病例报告旨在强调这种罕见疾病的特征和治疗。