Spinal cord compression of primary extragonadal giant yolk sac tumor
Spinal cord compression of primary extragonadal giant yolk sac tumor
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DOI：
10.1038/sj.sc.3101942
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发表时间：
2007-03-01
期刊：
影响因子：
2.2
通讯作者：
Seckin, H.
中科院分区：
文献类型：
--
作者：
Guzel, A.;Tatli, M.;Seckin, H.
研究设计：病例报告目的：报告一位成年男性原发性性腺外巨大卵黄囊瘤患者，以急性脊髓压迫为表现，地点：土耳其迪亚巴基尔迪克尔大学医学院。方法：一位31岁的男性患者被诊断为Pott病，主诉背痛和步态困难2周。神经系统检查显示痉挛性轻瘫和L2皮节水平以下的感觉减退。他还患有尿失禁。腹部电脑断层及腰椎磁振造影检查发现一个巨大的囊性肿块位于腰大肌。后方，第三腰椎椎体破坏，肿瘤压迫硬膜囊。采用前后联合入路。结果：术后病人神经功能有明显改善。化疗方案包括博莱霉素、足叶乙甙和顺铂。五个月后，最后一次化疗，他被带到急诊室败血症和死亡，尽管antibiotherapy.Conclusion：卵黄囊瘤应考虑在年轻的成年男性患者出现急性下肢轻瘫，即使没有任何迹象或病史的睾丸肿瘤。这些肿瘤可能无法切除;然而，神经结构减压和脊柱内固定可能导致神经功能缺损和疼痛缓解的实质性改善。
Study design: Case report.Objective: To report an adult male patient witha primary extragonadal giant yolk sac tumor presenting with acute spinal cord compression.Setting: Faculty of Medicine, University of Dicle, Diyarbakir, Turkey.Method: A 31-year-old man was referred to our department witha diagnosis of Pott's disease, a complaint of back pain and gait difficulty for 2 weeks. Neurological examination showed spastic paraparesis and hypoesthesia below the L2 dermatome level. He also had urinary incontinence. Abdominal computed tomography and lumbar magnetic resonance imaging study revealed a giant cystic mass lesion located in the psoas muscle. Posteriorly, the third lumbar vertebral body was destructed and the tumor was compressing the dural sac. A combined anterior and posterior approach was performed. Pathological diagnosis was a yolk sac tumor.Result: His neurological status improved during the postoperative course. A chemotherapy protocol was given including bleomycin, etoposide and cisplatin. Five months after the last chemotherapy, he was brought to the emergency unit in sepsis and died despite antibiotherapy.Conclusion: Yolk sac tumor should be considered in young adult male patients presenting with acute paraparesis even without any signs or medical history of a testis tumor. These tumors may be unresectable; however, decompression of neural structures and stabilization of the spine with instrumentation may cause substantial improvement in neurological deficit and pain relief.