持续胸痛4个月及进行性下肢无力2个月

Persistent chest pain for 4 months and progressive lower limb weakness for 2 months in a boy

摘要:

患儿，男，5岁。因胸痛4个月，右下肢无力2个月，双下肢无力10 d入院，无排便、排尿障碍，无意识障碍，双下肢呈上运动神经元性瘫痪，无颅神经受累，无感觉障碍。脊髓MRI示颈6~胸2椎管内肿瘤，压迫脊髓。转入神经外科手术治疗，患儿手术切除肿瘤后逐渐康复，随访6年未复发。该患儿病理诊断为透明细胞型脑（脊）膜瘤（WHO Ⅱ级）。儿童胸痛伴运动障碍，应与脊膜瘤这种椎管内肿瘤鉴别。

Abstract:

A boy, aged 5 years, was admitted due to chest pain for 4 months, right lower limb weakness for 2 months, and weakness of both lower limbs for 10 days. There were no symptoms of defecation/urination disorders or disturbance of consciousness, and the boy had upper motor neuron paralysis in both lower limbs, without cranial nerve involvement or sensory disorder. Spine magnetic resonance imaging revealed tumor in the spinal canal between cervical vertebra 6 and thoracic vertebra 2, which put pressure on the spinal cord. He was transferred to the department of neurosurgery for surgical treatment and fully recovered after tumor resection, and no recurrence was observed after 6 years of follow-up. The pathological diagnosis was clear cell meningioma (WHO grade Ⅱ). For children with chest pain and dyskinesia, spinal meningioma should be considered.