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yxfbbiedtj · Wysłany: Pon 9:33, 14 Mar 2011

Lumbosacral epidural case of neuroendocrine carcinoma

Department of lordosis exists, no muscle tension, but the multi-faceted activity limitation, ~ S2 spinous processes and paraspinal soft tissue was tenderness,[link widoczny dla zalogowanych], left loin major muscle slightly plump. Outside the bilateral posterior superior iliac spine tenderness, percussion lumbosacral pain. Left lower limb below the level and depth of feeling and tendon reflexes are lost. Ipsilateral gluteus maximus muscle to the foot of severe atrophy. Pathological reflex was not elicited, straight leg raising test (+), anal reflex, no significant changes in the right lower limb. Lumbosacral x-ray no obvious abnormalities. Lumbosacral MRI (Fig. 1 to 3) shows Iq ~ S. Spinal epidural soft tissue mass with a larger s. Abnormal vertebral body signal, Tl signal even on the masses, and paraspinal soft tissue signal similar to irregular in shape. Signal to reduce the affected vertebra, the intervertebral disc normally ask; I ~ Prevertebral soft tissue, Iq ~ s. Section of the left psoas muscle, back muscles and deep sacral spine intrinsic muscles also see a similar signal change, and is continuous with the spinal lesion. Enhanced scan showed a mild heterogeneous enhancement the lesion, lesion border clear. Asked the hole left vertebral lesion expansion, Iq ~ s disappearance epidural fat, thecal sac compression right in front of the shift. Comments: ~ S. Section of spinal and paraspinal soft tissue lesions. Surgical and pathological findings: the left paraspinal muscle color dark, crisp, brittle, hard mixed with a few pieces of soft tissue pathology inspection removal of part C), a wide range of tumors, and asked by the vertebral lamina holes and gaps invasive spinal canal. ~ Spines sudden removal of case reports,[link widoczny dla zalogowanych], lamina and ligamentum flavum, epidural fat, see disappear, and there is a purple-red mass in the dural sac covering the left rear, from left to the Ministry of dural tail to the right. Tumor blood supply is not abundant, and the adhesion around the tumor length from ~ S top, medium hardness. I spit nerve root tumor tissue was wrapped. Endoscopic view: immunohistochemical CK (++), Desmin (a), S-100 (++)( Figure 4). Pathological diagnosis: ~ Sl epidural neuroendocrine cancer. Discussion of epidural extramedullary tumors account for about 25% of spinal tumors, the vast majority of malignant tumors, metastatic tumors or lymphoma usually more common in J. Mostly in the epidural space behind the rear or side (and therefore soft tissue rich vascular plexus). The front is only a potential space, often unilateral tumor growth, showed a soft tissue shadow epidural,[link widoczny dla zalogowanych], epidural fat, pressure or even disappear. As epidural compared with hard, low penetration of spinal tumor, and thus easy to vertical development,[link widoczny dla zalogowanych], may compress the vertebral, spinal and spinal cord, and even lead to partial or complete obstruction of cerebrospinal fluid circulation. When the tumor is often accompanied by forward growth of bone destruction adjacent to, but rarely by the intervertebral disc _ Q tired l. Origin of neuroendocrine tumors with endocrine function in the nerve tissue, are APUD cell tumors, including carcinoid, atypical cancer and small cell carcinoma of the lung to ask degeneration, gastrointestinal, breast and other parts more common, see also larynx, mediastinum,[link widoczny dla zalogowanych], gonads, paranasal sinuses and other parts of the report. Rare occurrence of epidural J, pathology of various shapes, the lack of specificity, it is qualitative difficulties, diagnosis still relies on pathological examination.