胸椎第三四節脊髓膜內髓外腺癌：個案報告

T3-4 intradural extramedullary adenocarcinoma: A case report

一般而言乳癌轉移至脊椎會降低患者生活品質，外科醫師必須考慮不同的處理方式來減輕疼痛，減少腫瘤範圍以及增加脊椎穩定性來改善神經學上造成的疾患。脊椎管內癌症轉移一般占所有脊椎腫瘤百分之五。這位個案為57歲女性，本身為乳癌患者，併有轉移至胸椎第三四節脊椎管內髓外處，入院前患者發現左側臀部麻痛及左側下肢無力兩週。患者接受胸椎第二三四節減壓性椎板切開術及腫瘤切除手術後，左側臀部麻痛和下肢無力的情形改善。因為單純脊椎管內轉移個案臨床少見，且通常伴隨有限的存活時間和局部神經學的缺損。此個案臨床神經學疾患也在手術切除腫瘤後，得到較好的控制和復原。

Metastases to the spine are a common manifestation of breast cancer considerably reducting the quality of life. Surgeon must consider various available approaches for de- creasing pain, reducing tumor burden, ensuring spinal stability and treating neurological disorders. Intradural lesions are rare, accounting for only 5% of spinal metastases. This case was a 57-year-old female with a history of breast cancer and an intradural extramedullary lesion at the T3-4 level of the thoracic spine. She had suffered from left hip numbness and lower left limb weakness for 2 weeks. After completion of T2-3-4 decompressive laminectomy with complete removal of the tumor, her left hip numbness was relieved and lower left limb muscle strength improved. Intradural metastases are rare and often associated with limited survival time and focal neurological deficits. In this case, the patient experienced marked improvement to her neurological deficit through decompression surgery and resection of the tumor.