Autograft-derived spinal cord mass following olfactory mucosal cell transplantation in a spinal cord injury patient
Autograft-derived spinal cord mass following olfactory mucosal cell transplantation in a spinal cord injury patient
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DOI：
10.3171/2014.5.spine13992
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发表时间：
2014-10-01
影响因子：
2.8
通讯作者：
Hitchon, Patrick W.
中科院分区：
文献类型：
--
作者：
Dlouhy, Brian J.;Awe, Olatilewa;Hitchon, Patrick W.
在过去的十年中，人类细胞移植和神经干细胞试验已经检验了这些治疗各种神经系统疾病的潜在疗法的可行性和安全性。然而，由于可能出现异位、不受控制的细胞生长和肿瘤形成，这些试验存在重大的安全性问题。作者提出了一名18岁的女性在T10-11时遭受完全性脊髓损伤的病例。受伤三年后，她仍然截瘫，并在受伤部位接受了嗅觉粘膜细胞植入。8年后，患者出现背部疼痛，影像学显示细胞植入部位有脊髓髓内肿块，需要切除。术中发现脊髓扩张伴多囊性肿块，内含大量粘稠样物质。组织学检查和免疫组化染色显示肿块主要由衬有呼吸上皮的囊肿、含杯状细胞的粘膜下腺和其间的神经细枝组成。这是首例人类脊髓肿块并发脊髓细胞移植和神经干细胞治疗的报道。鉴于出现的时间较长，所有细胞移植和神经干细胞植入患者的安全监测应维持多年。
Over the last decade, human cell transplantation and neural stem cell trials have examined the feasibility and safety of these potential therapies for treatment of a variety of neurological disorders. However, significant safety concerns have surrounded these trials due to the possibility of ectopic, uncontrolled cellular growth and tumor formation.The authors present the case of an 18-year-old woman who sustained a complete spinal cord injury at T10-11. Three years after injury, she remained paraplegic and underwent olfactory mucosal cell implantation at the site of injury. She developed back pain 8 years later, and imaging revealed an intramedullary spinal cord mass at the site of cell implantation, which required resection. Intraoperative findings revealed an expanded spinal cord with a multicystic mass containing large amounts of thick mucus-like material. Histological examination and immunohistochemical staining revealed that the mass was composed mostly of cysts lined by respiratory epithelium, submucosal glands with goblet cells, and intervening nerve twigs.This is the first report of a human spinal cord mass complicating spinal cord cell transplantation and neural stem cell therapy. Given the prolonged time to presentation, safety monitoring of all patients with cell transplantation and neural stem cell implantation should be maintained for many years.