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Vertebral Metastatic Meningioma: A Case Report

腦膜瘤合併脊椎轉移性病變:病例報告

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摘要


腦膜瘤是常見的原發性顱內腫瘤,其好發率僅次於神經膠質瘤。在中樞神經系統疾病中,腦膜瘤合併顱外轉移,在文獻統計上並不常見。根據以往記載,僅有少數案例報告。其中,好發之位置依比例多寡為:肺、腹腔內臟器官、頸部淋巴結、骨盆、長骨及脊椎等地方。轉移性病變常見於高惡性度之腦膜瘤,其中又以顱外脊椎轉移更為罕見 • 本病案為針對一名七十七歲女性,主訴症狀以腰背痛、僵硬、坐骨神經痛及漸進性下肢癱軟無力為表現。 X 光影像學檢查及電腦斷層及核磁共振掃瞄等系列檢查顯示:第三腰椎椎體部腫瘤壓迫所致。經過手術切除減壓及內固定治療後,症狀得以緩解改善。經由病史回溯,組織病理學証實為多年前復發性腦膜瘤,在多次手術治療後,併發顱外腰椎椎體轉移性腦膜瘤惡性病變。本文提出病患之治療過程及放射學檢查、組織病理學及相關文獻之回顧與討論。

關鍵字

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並列摘要


Meningiomas are generally considered to be a common intracranial neoplasm that rarely metastasizes extracranially, and distant vertebral metastasis, even from histologically benign meningiomas, has been quite rare in the literature. We present an unusual case of recurrent falx meningioma with possible extracranial metastasis to the third lumbar vertebral body in a 77-year-old woman. The metastatic lesion was noted about 11 years after cranial surgery. The histopathological findings changed from benign to malignant meningioma. We review the pertinent literature, clinical course, and discuss the surgical aspect, histopathological findings and modes of metastasis.

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