研究的目的/目的:研究的目的/目的:中枢神经系统(CNS),头骨,肛门鳞状细胞癌(SCC)的椎体转移是一种极为罕见的实体。我们报告了第一例原发性肛门SCC多发椎体转移的病例,目的是确定目标治疗策略。病例介绍:我们介绍了一名68岁男性因急性加重慢性下腰痛和左L2神经根病入院的病例。他的病史包括与人乳头瘤病毒有关的诊断,中度分化肛门SCC(cT3N0M0-IIB期),两年前接受标准放化疗方案治疗。脊柱磁共振成像显示L2椎体有一个孤立的实性病变。手术切除后,组织病理学检查证实诊断为中分化SCC。在1个月的放射随访中,在T7至T11水平发现了两个新的病变.对L2,T7和T11的转移定位进行了额外的化疗和放疗。两年的随访表明,疾病在放射学和临床上得到了很好的控制。为了补充我们的案子,关于中枢神经系统的系统文献综述,头骨,和椎骨转移和他们的治疗已经进行。结论:尽管提出了一些治疗椎体转移瘤的指南,目前,对于因肛门SCC引起的椎体转移的普遍接受的治疗策略尚未确定.根据我们的临床经验和文献综述,在肛门SCC的椎体转移的情况下,一个迅速和积极的,局部和系统,椎体病变的多模式治疗对于改善患者预后可能至关重要。
Purpose/aim of the study: Purpose/aim of the study:Central nervous system (CNS), skull, and
vertebral metastases from anal squamous cell carcinoma (SCC) are an exceedingly rare entity. We report the first
case of multiple
vertebral metastases from a primary anal SCC with the aim of define a target therapeutic strategy.Case presentation: We present the
case of a 68-year-old male admitted to our hospital for acute exacerbation chronic low back pain and left L2 radiculopathy. His medical history included the diagnosis of a human papilloma virus related, moderately differentiated anal SCC (cT3N0M0-stage IIB), treated with standard chemoradiotherapy regimen two years earlier. Spinal magnetic resonance imaging revealed an isolated solid lesion of the L2 vertebral body. After the surgical removal, histopathological examination confirmed the diagnosis of moderately differentiated SCC. At 1-month radiological follow-up, two new lesions at the level of T7 to T11 were identified. Additional chemotherapy and radiotherapy for metastatic localization of L2, T7, and T11 were administered. Two-year follow-up demonstrated a radiologically and clinically well-controlled disease. To supplement our
case, a systematic literature review on the CNS, skull, and
vertebral metastases and their treatments has been performed.Conclusion: Despite several proposed guidelines for the management of vertebral metastases, at present, a universally accepted treatment strategy for vertebral metastases from anal SCC has not been defined. Based on our clinical experience and literature review, in
case of
vertebral metastases from anal SCC, a prompt and aggressive, local and systemic, and multimodal treatment of the vertebral lesions may be paramount to improve the patient outcomes.