척수 압박을 초래한 척추체 혈관종 - 증례 보고 -
Vertebral Hemangioma Causing Cord Compression - A Case Report -
소속 상세정보
송재욱/Jae Wook Song
윤상민/이상형/이창훈/이승훈/이정훈/이승숙/Sang Min Youn/Sang Hyung Lee/Chang Hoon Rhee/Seung Hoon Lee/Jeung Hoon Lee/Seung Sook Lee
KMID : 0359819970260020287
Abstract
서 론
척추체의 혈관종은 흔한 양성 질환으로 우연히 발견되거나 요통이나 경부 동통 환자에서
진단 검사시 발견되기도 한다. 그 빈도는 많은 부검례나 일반 촬영에서 약 10-12% 정도로
추산된다. 드물게는 수술적 치료를 필요로 하는 척수 압박을 유발 할 수 있는데, 흉추부 척
추체 혈관종은 전이성 종양으로 진단될 수 있다. 본 병원에서는 척수 압박으로 나타난 척추
체 혈관종을 1례 치험하고 이의 방사선학적 진단 및 치료에 관하여 고찰하였다.
#초록#
We present a case of thoracic vertebral hemangioma causing spinal cord compression
in a 57-year-old man. It is not common for vertebral hemangioma to cause neurologic
deficits. The chief complaint of the patient was progressive paraparesis. Plain T-spine
x-rays appeared normal, Axial and sagittal T1-weighted magnetic resonance(MR)
imagings of T-spine showed multiple ring-like high signal lesion in vertebral body and
decreased signal intensity at T7 with epidural mass causing spinal cord compression.
Decompressive laminectomy and subtotal removal of the epidural mass were performed.
The mass was reddish, friable and easily-coagulated. The postoperative computerized
tomography(CT) scan of T-spine demonstrates characteristic thick vertical trabeculae
and honeycomb pattern involving body and pedicles of T7 vertebrae. Bowel and urinary
incontinece returned to normal two weeks following operation, and the patient was
discharged with walking by sue of crutch three weeks later. Based on clinical features
with this patients review of the literature, the authors recommend annual neurological
and radiological examinations for patients harbouring hemangiomas with associated pain.
Radiation therapy or embolization is an effective therapeutic alternatively for patients
with severe medically refractory pain.
It is concluded that management of patients with progressive neurological deficit
should include prompt preoperative angiography and embolization, decompressive surgery
with the approach determined by the degree of vertebral involvement and site of spinal
cord compression, and postoperative radiation therapy in patients in patients following
subtotal tumor removal.
키워드
Vertebral hemangioma; Spinal cord compression; Magnetic resonance image(MRI);
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