頸僵硬之成年女性的頸椎巨細胞瘤：病例報告

Giant-Cell Tumor of the Cervical Spine in an Adult Female with Neck Stiffness: A Case Report

朱冠宇(Kuan-Yu Chu) ； 劉文勝(Wen-Sheng Liu) ； 賴彥廷(Yen-Ting Lai) ； 莊以瀑(I-Pu Juang) ； 林樞寰(Shu-Huan Lin)

《台灣復健醫學雜誌》 40卷1期 (2012/03) Pp. 53-57

https://doi.org/10.6315/2012.40(1)08

摘要

骨巨細胞瘤在年輕人很常見，特別是三十歲左右，其好發於遠端股骨與近端脛骨，但發生在頸椎骨上卻是很少見。頸椎骨巨細胞瘤很少被放入頸部疼痛的鑑別診斷中，因此可能造成誤診或延遲診斷。本篇報告一位25歲女性，初期診斷為頸部肌肉拉傷，三天後合併上半身麻痛，X光檢查發現第四頸椎病理性骨折；磁振造影檢查顯示第四頸椎脊椎腫瘤且壓迫脊髓，而後接受腫瘤切除手術，術後病理切片檢查確定為巨細胞瘤；患者術後恢復良好，無明顯的神經功能損傷。本報告針對骨巨細胞瘤的臨床表現和頸部僵硬與疼痛的鑑別診斷，做相關性探討和文獻回顧，傳統之X光檢查仍扮演重要角色。（台灣復健醫誌2012；40（1）：53 - 57）

關鍵字

巨細胞瘤 ； 頸部疼痛

並列摘要

Giant-cell tumor of the bone is relatively common in young adults, especially those in the third decades of life. This tumor occurs most frequently in long bones, such as the distal femur or proximal tibia, but rarely in the cervical spine. Giant-cell tumor of the cervical spine is rarely considered in the differential diagnosis of neck pain; thus, diagnosis of giant-cell tumor of the cervical spine is typically delayed or misdiagnosed. We present a case of giant-cell tumor of the cervical spine in a 25-year-old woman initially diagnosed with neck stiffness and muscle strain. She developed upper trunk numbness in 3 days. An X-ray of the patient's cervical spine revealed a pathological fracture of the fourth vertebra. Magnetic resonance imaging also showed a tumor-like lesion compressing the spinal cord at the fourth vertebra. The patient underwent surgical tumor resection, and the pathologic findings of the lesion finally confirmed a diagnosis of giant-cell tumor. Following surgery, the patient experienced good recovery without any obvious neurologic deficits. We present this case to discuss the clinical manifestations of giant-cell tumor of the bone and the differential diagnosis of neck stiffness and pain with a review of current literature. Additionally, conventional plain films play a role in common screening. (Tw J Phys Med Rehabil 2012; 40(1): 53 - 57)

並列關鍵字

giant-cell tumor ； neck pain