背景:由于与良性肿瘤相似,腺泡细胞癌(ACC)的诊断和治疗通常具有挑战性,晚期复发和远处转移的发生率高,对全身化疗有抗性.尚未报道导致硬膜内髓外肿块的原发性腮腺ACC。
方法:作者描述了这样一个病例,在初次诊断29年后表现为进行性脊髓型颈椎病。肿瘤,位于C2-C3级别,渗入硬脑膜,并包含硬膜外和硬膜内成分。这发生在同一位置的硬膜外转移不完全切除后18个月。
结论:尽管各种原发性恶性肿瘤的颅内和硬膜外转移已得到充分报道,继发性脊髓硬膜内恶性肿瘤很少见。因此,硬膜内髓外转移的外科治疗尚无既定指南,预后可能难以确定.在这种情况下,由于全身治疗方案已经用尽,因此治疗方案有限,因此不建议对该区域进行重复放疗.我们报道了这种情况,以强调脊柱转移后罕见的局部复发导致硬膜内髓外肿瘤的临床过程,并表明手术干预可以改善神经系统症状。
BACKGROUND: The diagnosis and management of acinic cell carcinoma (ACC) is often challenging given its similarity to benign tumors, high incidences of late recurrence and distant metastasis, and tendency to be resistant to systemic chemotherapy. A primary parotid ACC resulting in an intradural extramedullary mass has not been reported.
METHODS: The authors describe such a
case that presented as a progressive cervical myelopathy 29 years after initial diagnosis. The tumor, located at the C2-C3 level, infiltrated the dura and contained both extradural and intradural components. This occurred 18 months after the incomplete resection of an extradural metastasis at the same location.
CONCLUSIONS: Although intracranial and extradural metastases of various primary malignancies are well reported, secondary spinal intradural malignancies are rare. As a result, there are no established guidelines for the surgical management of intradural extramedullary metastases and prognosis may be difficult to establish. In this
case, treatment options were limited because systemic therapy options had been exhausted and repeated radiation to the area was not recommended. We report on this
case to highlight the clinical course of a rare local recurrence after spinal metastasis leading to an intradural extramedullary tumor and to show that surgical intervention can lead to improvement of neurological symptoms.