临床肿瘤学杂志

• 临床应用 • 上一篇    下一篇

骶骨外脊柱少见部位脊索瘤的临床病理特征分析

杨勇昆,牛晓辉,李兰,丁宜   

  1. 100035 北京积水潭医院骨肿瘤科
  • 收稿日期:2015-02-26 修回日期:2015-04-08 出版日期:2015-07-31 发布日期:2015-07-31

Clinicopathological characteristics of mobile spinal chordoma

YANG Yongkun, NIU Xiaohui, LI Lan, DING Yi.   

  1. Department of Orthopaedic Oncology, Beijing Jishuitan Hospital, Beijing 100035, China
  • Received:2015-02-26 Revised:2015-04-08 Online:2015-07-31 Published:2015-07-31

摘要: 目的 探讨发生于脊柱少见部位的脊索瘤的临床特点及诊断和治疗方法。方法 收集2001年12月至2013年10月发生于颈、胸、腰椎的6例脊索瘤患者的临床资料,包括临床表现、影像学和病理学特点以及接受外科治疗的情况。结果 6例脊索瘤的发生部位:腰椎3例,颈椎2例,胸椎1例。6例均接受手术治疗,术后随访时间平均38.7个月(12~45个月)。术后复发2例,均为囊内切除边界。1例全身多发转移,术后5个月死亡。病理组织学检查均表现为脊索瘤经典型形态:肿瘤细胞片状分布或呈条索状和散在分布于丰富的黏液性间质中,肿瘤细胞主要由含空泡的液滴样细胞和嗜酸性星形细胞构成。结论 颈、胸、腰椎脊索瘤罕见,临床症状多不典型,容易漏诊或误诊,需结合影像学和病理学表现诊断,囊内切除后复发率高。

Abstract: Objective To investigate the clinicopathological characteristics and the methods of diagnosis and treatment of chordoma sites occurred in rare mobile spine. Methods The clinical data of six cases of spinal chordoma occurred in cervical, thoracic and lumbar from December 2001 to December 2013 in our center were analyzed, which including clinical manifestations, radiological features, pathological diagnosis, and surgical treatment. Results There were three cases in lumbar vertebrae, two cases in cervical vertebrae and one case in thoracic vertebrae. All cases received surgical treatment. The average postoperative follow-up time was 38.7(12-45) months. Recurrence occurred in two cases which had intracapsular resection margin. One patient died of multiple metastases postoperative. Pathology showed classic chordoma morphology. Tumor cells showed a patchy distribution or cords and scattered in mucinous abundant interstitial. The tumor was composed of droplets like cells containing vacuole and eosinophilic astrocytes. Conclusion The cervical, thoracic and lumbar spinal chordomas are rare. The clinical symptoms are not typical and easily missed or misdiagnosed. The diagnosis should combine with radiological and pathological characteristic. The recurrence rate is high after intracapsular excision.

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