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少数恶性肿瘤患者神经系统受损表现出现在其它临床表现之前,成为首诊的原因.本文报告7例以颈肩痛为首发症状的癌性感觉神经病.1 病例资料男6人,女1人,年龄39～69岁,平均54岁,7例均呈亚急性起病,初诊为颈椎病6例,待查1例.后经手术病理诊断肺癌4例、胃癌1例,前列腺癌1例、肾癌1例.7例均排除可引起感觉神经障碍的其它原因.首发症状为持续性单侧颈肩痛4例,阵发性两侧颈肩痛1例,阵发性单侧颈肩痛2例.其它临床表现有食欲下降、消瘦1例,刺激性干咳3例,咳血1例,无痛性血尿1例、尿痛1例.从出现首发症状至出现其它临床表现的时间最短3个月,最长1年零3个月.腰穿7例,奎肯氏试验及脑脊液生化检查均正常.7例经糖皮质激素、消炎痛或布洛芬治疗疗效不佳,7例原发肿瘤切除后,颈肩痛症状均缓解.
The manifestations of neurological impairment in a few patients with malignant tumors appear before other clinical manifestations and become the reason for the first diagnosis. This article reports 7 cases of cancerous sensory neuropathy with neck and shoulder pain as the first symptom. 1 Case data 6 males and 1 females Age 39-69 years old, average 54 years old, 7 cases were all subacute onset, 6 cases were newly diagnosed as cervical spondylosis, 1 case was pending. After surgical pathological diagnosis of 4 cases of lung cancer, 1 case of gastric cancer, 1 case of prostate cancer, kidney In 1 case, 7 cases of cancer were excluded from other causes of sensory neurological disorders. The first symptoms were persistent unilateral neck and shoulder pain in 4 cases, paroxysmal bilateral neck and shoulder pain in 1 case, paroxysmal unilateral neck and shoulder pain 2 Other clinical manifestations include loss of appetite, weight loss in 1 case, irritating cough in 3 cases, hemoptysis in 1 case, painless hematuria in 1 case, and urinary pain in 1. The shortest time from the onset of symptoms to the appearance of other clinical manifestations was 3 Months, up to 1 year and 3 months. 7 lumbar punctures, Quikner’s test and biochemical examination of cerebrospinal fluid were normal. 7 cases were ineffective by glucocorticoid, indomethacin, or ibuprofen, and 7 cases were primary tumors. After the resection, the symptoms of neck and shoulder pain were relieved.