Primary Osteosarcoma of the Spine: A Case Report

原發性脊椎骨肉瘤：病例報告

張旭超(Hsu-Chao Chang) ； 林坤榮(Kun-Eng Lim) ； 許元昱(Yuan-Yu Hsu) ； 詹正義(Cheng-Yi Chan) ； 郭秀雯(Hsiu-Wen Kuo) ； 蔡悅華(Yueh-Hua Tsai)

《中華放射線醫學雜誌》 32卷4期 (2007/12) Pp. 217-222

摘要

原發性的脊椎骨肉瘤是一種罕見的疾病。我們在此報告一個62歲的女性病人，因為近幾天越來越嚴重的胸悶、頭痛、尿失禁、與雙側下肢無力而求診。胸部及頸椎X光片發現在左側上縱膈腔與下頸部有一個骨化的腫塊合併周遭骨頭破壞。胸部電腦斷層和脊椎核磁共振掃描發現在第七頸椎與第一、二胸椎有一個包含軟組織與骨化的腫塊，侵犯到脊椎體、脊椎後部、周圍軟組織、及硬膜外腔。椎間盤部分則沒有受到侵犯。影像學的檢查對此疾病的偵測、鑑別診斷、及分期是很有幫助的。如果一個中年人，在他的脊椎體及脊椎後部有一個大型的骨化腫塊，我們須將原發性的脊椎骨肉瘤放入鑑別診斷之中。

並列摘要

Primary osteosarcoma of the spine is an uncommon disease. Here we report a 62-year-old female who suffered from progressive chest tightness, dizziness, urinary incontinence, and bilateral lower legs weakness for days. Chest and cervical spine radiographs revealed a large expansile mass with extensive ossifications and adjacent bone destructions in left superior mediastinum and lower neck. Chest CT and spinal MRI scans revealed a large mass with soft tissue components and extensive ossifications involving body, posterior element, paravertebral soft tissue, epidural space, and rib in C7, T1, and T2 levels. The intervertebral disc spaces were spared. Imaging studies are useful for detection, differential diagnosis, and staging of this disease. When a large mineralized tumor involves body and posterior element of the spine in a middle-age person, primary spinal osteosarcoma may be considered in the differential diagnosis.