CAJ | 학술논문

脊膜瘤是常见的椎管内良性肿瘤之一，起源于蛛网膜内皮细胞或硬脊膜的纤维细胞，多发于40～70岁女性，主要见于胸段，颈段次之，腰段少见。脊膜瘤生长缓慢，主要临床表现为慢性进行性脊髓压迫症状，影像学检查有助于明确诊断。该文报道1例胸椎脊膜瘤合并糖尿病患者，其有糖尿病史5年，因下腹部及双下肢麻木就诊，初诊为糖尿病性周围神经病变，经甲钴胺、依帕司他治疗无好转。其后再行 MRI 检查发现其胸椎2～3椎体后方髓外硬膜下有占位性病变，考虑为脊膜瘤，接受椎管内肿瘤摘除术治疗，活组织病理学检查明确诊断为胸椎脊膜瘤。术后随访患者无再出现下腹部及肢体麻木，胸椎脊膜瘤无复发。由此可见，对于伴有肢体麻木的糖尿病患者，不能仅考虑糖尿病性周围神经病变的可能，应注意排除脊膜瘤。
척막류시상견적추관내량성종류지일，기원우주망막내피세포혹경척막적섬유세포，다발우40～70세녀성，주요견우흉단，경단차지，요단소견。척막류생장완만，주요림상표현위만성진행성척수압박증상，영상학검사유조우명학진단。해문보도1례흉추척막류합병당뇨병환자，기유당뇨병사5년，인하복부급쌍하지마목취진，초진위당뇨병성주위신경병변，경갑고알、의파사타치료무호전。기후재행 MRI 검사발현기흉추2～3추체후방수외경막하유점위성병변，고필위척막류，접수추관내종류적제술치료，활조직병이학검사명학진단위흉추척막류。술후수방환자무재출현하복부급지체마목，흉추척막류무복발。유차가견，대우반유지체마목적당뇨병환자，불능부고필당뇨병성주위신경병변적가능，응주의배제척막류。
[Absract] Meningioma is a common type of vertebral canal benign tumor arising from the arachnoid endothelial cells or dura mater fibrocytes.It is mainly observed in females aged 40-70 years with the predilec-tion sites of thoracic segment followed by neck segment,occasionally in the lumbar segment.Meningioma grows slowly and is mainly manifested with chronic progressive spinal cord compression.Imaging examination contrib-utes to the definite diagnosis.Herein,we reported one case of thoracic spinal complicated with 5 years of dia-betes mellitus.The patient was admitted to our hospital due to lower abdominal and bilateral lower extremity numbness and preliminarily diagnosed as diabetic peripheral neuropathy.The symptoms were not improved after methylcobalamin and epalrestat therapy.Subsequent MRI examination revealed subdural extramedullary space-occupying lesions posterior to the vertebrae 2 and 3,considered as meningioma.The patient underwent intraca-nal tumor resection and thoracic spinal meningioma was confirmed by postoperative histopathology.During post-operative follow-up,relevant symptoms were absent and thoracic spinal meningioma did not recur.Consequent-ly,both diabetic peripheral neuropathy and meningioma should be considered for the diabetic patients compli-cated with limb numbness.