胸椎の巨細胞腫:脊髄圧迫の稀な原因

Ghassen Gader1, Fatma Ben Attig1, Wiem Mansour2

  • 1Department of Neurosurgery, Trauma and Burns Center, Ben Arous. University of Tunis - El Manar, Faculty of Medicine of Tunis, Tunisia.

Radiology case reports
|April 28, 2025
PubMed

骨の巨細胞腫(GCT)は稀な腫瘍であり、通常は長管骨の骨幹端に発生し、脊椎、特に胸椎領域に発生することは極めて稀である。本報告では、乾癬とセリアック病の既往があり、進行性の炎症性腰背痛および対麻痺を呈した34歳の女性の症例を報告する。画像診断により、T11椎体に骨溶解性腫瘤が認められ、背側脊髄圧迫を引き起こしていた。緊急手術が施行され、病理組織学的検査によりGCTであることが確認された。術後、運動機能は当初回復したが、その後、脊椎の不安定性を防ぐために外科的固定術が必要となった。患者には補助療法としてデノスマブ投与が開始され、経過観察中も無症状である。本症例は、胸椎におけるGCTの稀少性と、それに伴う診断および治療上の課題を浮き彫りにしている。GCTは良性ではあるが、重度の脊髄圧迫を引き起こす可能性があり、神経機能を維持するためには迅速な外科的介入が必要である。デノスマブ療法は、腫瘍の進行制御および手術成績の向上において有望である。再発を防止し予後を改善するためには、多職種連携による管理と定期的なフォローアップが不可欠である。

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