経皮的椎体形成術を施した精巣腫瘍椎骨転移

Percutaneous injection of surgical bone cement in patient with vertebral metastasis of testicular tumor

　36歳，男性。両下肢のしびれを主訴に受診した。3年前に右精巣腫瘍（胎児性癌，T2，N0，M0，S0）で高位精巣摘除術が施行されている。HCG-β 4.0ng/ml，画像診断で左腸骨前面の腫瘤性病変，第3・11胸椎への骨転移を認めた。化学療法後腫瘤性病変は消失したが，第11胸椎の溶骨性変化は改善せずCTガイド下経皮的椎体形成術を施行した。治療後自力歩行可能となり骨硬化像を認めた。

A 36-year-old man presented with a lumbar pain and a numbness of bilateral lower limbs 42months after right orchiectomy with a pathological diagnosis of embryonal testicular carcinoma,T2,N0,M0,S0. CT-scan and bone scintigraphy revealed metastases of thoracic vertebrae（Th3 and Th11）and soft tissues located in the front of left iliac bone. After a successful chemotherapy,CT guided percutaneous vertebroplasty（Th11）using surgical bone cement was performed to prevent tumor related vertebral fractures. No trouble was found during and after this procedure. A good bone stabilization has been obtained and tumor markers continue to be in normal range 18months after percutaneous vertebroplasty.（Rinsho Hinyokika 60：497-500,2006）