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Rehabilitation Practice and Science

Translated Title

脊髓內星狀細胞瘤以頸背痛症狀呈現：病例報告

Abstract

Intramedullary astrocytomas are rare, accounting for 3% of all central nervous system astrocytomas. Pain is the most common clinical symptom, although symptoms can vary. These tumors typically progress over a period of months to years before the diagnosis is established. An intramedullary astrocytoma and cervical intervertebral disc herniation may coexist; the early symptoms maybe similar and an intramedullary astrocytoma might go undetected and be misdiagnosed as cervical disc herniation. This paper reports a 30-year-old male who presented with cervical and upper back pain extending to the right upper limb. Initially, the diagnosis was a cervical radiculopathy. After rehabilitation, for two months, the patient improved. However, the symptoms recurred one month later. This time, the response to rehabilitation was unsatisfactory and the pain increased in severity, now including night pain and loss of neurological function, including loss of pain and temperature sensation in the right trunk and upper limb, right hand weakness, as well as increased deep tendon reflexes. Magnetic resonance imaging (MRI) led to the diagnosis of cervical intervertebral disc herniation (C5-6), and a cervical and thoracic intramedullary tumor (C4-T7) with syringomyelia. Because the tumor was infiltrative, a total gross resection could not be accomplished, and therefore only a biopsy was performed. Pathological examination confirmed the diagnosis of an anaplastic astrocytoma. Six months after completion of radiotherapy and chemotherapy, the follow-up MRI showed that the syrinx had decreased and the intramedullary tumor could not be visualized. The cervical and upper back pain decreased. Pain and temperature sensation of the trunk and upper limb recovered and the right upper limb regained strength. Here, the differential diagnosis of cervical radiculopathy is discussed as well as the clinical presentation and treatment of intramedullary astrocytomas with a reviewarticle of the relevant literature.

Language

Traditional Chinese

First Page

69

Last Page

76

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