肺癌脊髓髓内转移1例报道及文献复习

发布时间：2018-02-09 19:32

本文关键词： 肺癌脊髓髓内转移瘤治疗预后　出处：《蚌埠医学院》2016年硕士论文　论文类型：学位论文

【摘要】：脊髓髓内转移瘤(Intramedullary Spinal Cord Metastasis,ISCM)是一种非常罕见的神经系统转移瘤,病情进展迅速、预后较差。ISCM最常见的来源为肺癌,其次为乳腺癌。本文报告2013年我院收治肺癌脊髓髓内转移患者1例并文献复习,该患者男性,43岁,20余年吸烟史,2012年11月诊断为肺癌脑转移,2012年12月底患者出现右下肢麻木无力并进行性加重,进而发展至双下肢麻木无力,不能下床行走,予胸腰骶椎MRI增强示:T9/10椎体平面脊髓内占位性病变,结合病史考虑为转移瘤或室管膜瘤。予肺部原发灶及脊髓内转移灶姑息放疗,DT=36Gy/20f,放疗后患者双下肢肌力有所回升。后又出现多发转移予顺铂+依托泊苷化疗4周期,依托泊苷0.1d1-5+顺铂30mgd1-4。病情一直进展于2013年10月死亡。为了提高对ISCM的认识,我们基于本病例,复习国内外文献,旨在探讨脊髓髓内转移瘤的临床特征、诊断、治疗及预后,进一步明确ISCM的诊疗规范。
[Abstract]:Spinal cord intramedullary Spinal Cord Metastasism is a very rare neurometastases with rapid progression and poor prognosis. The most common source of ISCM is lung cancer. In 2013, a case of intramedullary metastasis from lung cancer to spinal cord was treated in our hospital and the literature was reviewed. In November 2012, he was diagnosed as brain metastases of lung cancer. At the end of December 2012, the patient developed numbness and weakness of right lower extremity and progressive aggravation, and then developed numbness and weakness of both lower limbs and could not walk out of bed. MRI enhancement of thoracolumbar sacral vertebrae showed a space-occupying lesion in the spinal cord in the plane of the vertebrae of: T9 / 10. After palliative radiotherapy in primary lung and spinal cord, DT36Gy / 20f. after radiotherapy, the muscle strength of the lower extremities of the patients increased, and then multiple metastasis to cisplatin etoposide for 4 cycles, after which the patient was considered as metastatic tumor or ependymoma, or ependymoma, or ependymoma, or ependymoma, or ependymoma. Etoposide 0.1 d 1-5 cisplatin 30mgd1-4. In order to improve the understanding of ISCM, we reviewed the domestic and foreign literature based on this case to explore the clinical features, diagnosis, treatment and prognosis of spinal cord intramedullary metastases. To further clarify the diagnosis and treatment of ISCM.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R734.2

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