METHODS: A 6-year-old boy presented with muscle weakness in the right deltoid (2) and biceps (4) during a manual muscle test. Magnetic resonance imaging showed a 3 × 2 × 1.5 cm mass within the spinal canal at the C4-6 level, compressing the cervical spinal cord from the right side. Computed tomography revealed hyperintense areas within the tumor and ballooning of the right C4-5 and C5-6 facet joints.
RESULTS: After a biopsy confirmed the absence of malignancy, a gross total resection was performed. The pathological diagnosis of synovial osteochondromatosis was established. Postoperatively, muscle weakness improved fully in the manual muscle test, and there were no neurological findings after 3 months. However, the patient is under careful follow-up owing to the detection of a regrowth site within the right C4-5 and C5-6 intervertebral foramen 2 years postoperatively.
CONCLUSIONS: Synovial osteochondromatosis of the cervical spine in children is rare, and this is the first report of its regrowth after surgery. Synovial osteochondromatosis should be included in the differential diagnosis of pediatric cervical spine tumors.
方法:一名6岁男孩在手动肌肉测试中出现右三角肌(2)和二头肌(4)肌肉无力。磁共振成像显示,C4-6水平的椎管内有3×2×1.5cm的肿块,从右侧压缩颈脊髓。计算机断层扫描显示肿瘤内的高强度区域以及右C4-5和C5-6小关节的膨胀。
结果:活检证实没有恶性肿瘤,进行了大体全切除.建立滑膜骨软骨瘤病的病理诊断。术后,肌肉无力在手动肌肉测试中得到充分改善,3个月后没有神经系统检查结果。然而,由于术后2年在右侧C4-5和C5-6椎间孔内检测到再生部位,患者正在接受仔细的随访.
结论:儿童颈椎滑膜骨软骨瘤病很少见,这是它手术后再生的第一份报告。小儿颈椎肿瘤的鉴别诊断应包括滑膜骨软骨瘤病。