背景:脉络膜瘤是一种罕见的良性肿瘤,其特征是在异常解剖位置存在正常组织。相比之下,脉络膜瘤往往发生在其他身体部位,而不是在椎管内。在我们的发现之前,仅记录了4例椎管内脉络膜瘤。因为它的成分复杂且非常罕见,常规检查,比如磁共振成像,很难诊断,其发生的可能性在临床诊断中常被漏诊。如果其组分没有特异性,比如在这种情况下,即使是病理检查也只能在排除其他可能性后确认诊断为脉络膜瘤。因此,在临床实践中,当遇到椎管内肿瘤患者时,必须考虑脉络膜瘤的可能性。在这种情况下,脉络膜瘤缺乏特定的组成成分,将其与先前报道的椎管内脉络膜瘤区分开来,显著提高了诊断挑战,这为临床诊断提供了有价值的见解。
方法:一名年龄为48岁的女性患者因持续的下背部疼痛并伴有双腿放射状疼痛5个月而被我们的医疗中心收治。根据神经体格检查和磁共振成像的结果,该患者被诊断为位于第一腰椎椎体水平的硬膜内占位性病变。我们进行了增强的磁共振神经造影检查,以进一步确定职业与神经之间的位置关系,为手术做准备。术后病理活检显示肿块为椎管内脉络膜瘤。
方法:硬膜内髓外脊索瘤。
方法:手术切除病灶。
结果:手术后,所有症状都明显缓解,当病人出院时,所有症状完全消失。随访1年后无复发迹象。
结论:椎管内脉络膜瘤没有特异性,需要通过病理检查来诊断。早期发现和干预椎管内肿瘤可以减轻神经功能障碍。
BACKGROUND: A choristoma is a rare and benign neoplasm characterized by the presence of normal tissue in an anomalous anatomical location. In contrast, choristoma tend to occur in other body regions rather than within the spinal canal. Before our findings, only 4 cases of intraspinal choristoma had been recorded. Because its composition is complex and very rare, routine examinations, such as magnetic resonance imaging, are difficult to diagnose, and the possibility of its occurrence is often missed in clinical diagnosis. If there is no specificity in its components, such as in this
case, even pathological examinations can only confirm the diagnosis as choristoma after eliminating other possibilities. Therefore, in clinical practice, when encountering patients with intraspinal tumors, it is essential to consider the possibility of choristoma. In this
case, the choristoma lack of specific constituent composition sets it apart from previously reported intraspinal choristoma, significantly raising the diagnostic challenge, which offers valuable insights for clinical diagnosis.
METHODS: A female patient aged 48 years was admitted to our medical center due to experiencing persistent lower back pain accompanied by radiating pain in both legs for 5 months. Based on the findings from the neurological physical examination and magnetic resonance imaging, the patient was diagnosed with an intradural space-occupying lesion located at the level of the first lumbar vertebral body. We performed an enhanced magnetic resonance neurography examination to further determine the positional relationship between the occupation and nerves in preparation for surgery. Postoperative pathological biopsy showed that the mass was an intraspinal choristoma.
METHODS: Intradural extramedullary spinal choristoma.
METHODS: Occupied lesion is removed surgically.
RESULTS: After surgery, all symptoms were significantly relieved, and when the patient was discharged, all symptoms disappeared completely. There was no sign of recurrence after 1 year of follow-up.
CONCLUSIONS: Intraspinal choristomas are not specific and need to be diagnosed by pathologic examination. Early detection of and intervention for intraspinal tumors can mitigate nerve dysfunction.