菌血症随伴性椎体周囲膿瘍と鑑別を要した胸椎脊索腫

Thoracic Spinal Chordoma Need to be Differentiated from the Bacteremia-associated Paravertebral Abscess

肺炎などを原因とする菌血症において，血行性感染により椎体周囲膿瘍を発症することが知られている1，2）．一方，脊索腫は，頭蓋底や仙骨に好発する脊索由来の骨腫瘍で，胸椎に発生することは非常にまれである．われわれは，肺炎による菌血症随伴性椎体周囲膿瘍と鑑別が困難であった胸椎原発脊索腫の1例を経験したので報告する．

A 71-year-old woman presented to our hospital with fever and dyspnea. Computed tomography showed shadows of bilateral pneumonia and anterior vertebral mass. She was admitted to our hospital for respiratory failure. Despite treatment with antibiotics, she developed right thoracic empyema. A high level of inflammation and fever persisted, despite chest tube drainage and continued treatment with antibiotics. Therefore, thoracoscopic curettage was conducted. The histopathological findings of the curetted anterior vertebral body lesion revealed the diagnosis of chordoma. After confirming that all the culture results and inflammation findings had turned negative, the patient was discharged from the hospital. Thoracic vertebral chordoma is being treated at the department of orthopedics.