Metastatic Tumor in the Atlantoaxial Spine: A Case Report

寰樞椎惡性腫瘤轉移：病例報告

吳欣治(Hsin-Chi Wu) ； 邱建才(Chieh-Tsai Chiu) ； 葉步盛(Pu-Sheng Yeh) ； 洪怡珣(Yi-Shiung Horng)

《台灣復健醫學雜誌》 34卷2期 (2006/06) Pp. 97-102

https://doi.org/10.6315/2006.34(2)05

摘要

頸椎惡性轉移腫瘤是頸椎疼痛鑑別診斷之一。在此病例報告中，病患因頸部疼痛早先以頸椎關節炎於某一醫學中心接受頸椎牽引，後因氣胸住進本院胸腔科病房。在復健科照會中，理學檢查發現頸椎旋轉活動度降低、後腦麻感，懷疑第一二頸椎問題而接受以下檢查。X-ray檢查顯示頸椎第一二節滑脫，後續之電腦斷層及磁振造影檢查證實頸椎第二節腫瘤。在轉移性頸椎腫瘤的診斷下接受頸部固定手術，化學治療及放射治療。在文獻中顯示，頸椎腫瘤通常只以頸部疼痛為唯一症狀，出現神經症狀者少；主要的轉移源為肺癌及乳癌。治療則以保守治療為主。頸椎疼痛及不穩(unstable or subluxation)時接受後側固定手術(posterior fixation)。

關鍵字

脊椎轉移性腫瘤 ； 頸痛 ； 寰樞椎

並列摘要

Atlantoaxial involvement is rare in metastatic tumors of the spine. We report a case of atlantoaxial metastatic adenocarcinoma of pulmonary origin, which was treated as cervical spondylosis because the first clinical manifestations were cervical pain followed by limitation of rotation. In the literature, most authors stated that in patients with cervical spine metastases but without neurological signs, pain may be the only complaint. Most metastasized tumors of the atlantoaxial spine originate in the lung or breast. The goal of treatment for these cases is palliative. Posterior fixation is indicated for patients having intractable pain or whose cervical spine is unstable. Conservative treatment for the rest of their lives is recommended for these patients.

並列關鍵字

cervical metastasis ； cervical pain ； atlantoaxial spine