Low back pain is actually this kind of cancer? An expert from Zhejiang: Do not take low back pain lightly, it will kill you when it is serious

A while back

We wrote a popular science about low back pain

Common low back pain

It could be an abdominal aortic aneurysm with an 88% mortality rate

If not found in time

Consequences

Recent

The Department of Vascular Surgery, Zhijiang Campus of the First Hospital of Zhejiang University admitted another case of special “low back pain”

It turns out to be a rare cancer in the world

What’s going on here?

Aunt Chunan has low back pain for one year

Can’t figure out why

Aunt Qian (pseudonym) is from Chun’an. She is 58 years old this year. She and her husband opened a breakfast shop in the town in the early years. , Now that the children have married and established a family, Aunt Qian should stop working so hard, but she said that she could not be idle, and she still opened up shops all these years.

Since last summer, Aunt Qian always felt low back pain. She thought she was tired at first, so she rested for a while, but the low back pain did not relieve.

Aunt Qian came to the local hospital. The doctor first thought that she might have nephritis, but after a series of examinations, kidney disease was ruled out; Aunt Qian came to the orthopedics department again, and underwent lumbar MRI and other examinations. , Aunt Qian had a little lumbar disc herniation, but after treatment, the effect was not good, and it even became more and more serious. At this time, another person recommended Aunt Qian to go to the pain department for treatment, but after going to many hospitals, Aunt Qian’s low back pain still plagued her daily.

“It won’t work like this, or you should go to Hangzhou University Hospital again.” Aunt Qian’s husband was also anxious, and brought his wife to Zhijiang, the First Affiliated Hospital of Zhejiang University School of Medicine Courtyard.

It is a rare disease in the world

Multidisciplinary Collaboration “Bomb Defusing”

When I came to Zhijiang Campus, what kind of department should I see, Aunt Qian was worried again. At this time, her husband vaguely remembered that a doctor had said that it might be a blood vessel problem, so they walked in Went to the expert clinic of Tian Lu, Deputy Chief Physician of Vascular Surgery.

Carefully reviewed Aunt Qian’s reports. The experienced deputy chief physician Tian Lu considered whether it might be a problem with the inferior vena cava after excluding a variety of diseases.

The inferior vena cava is the largest venous trunk in our body. It collects venous blood from the lower body and returns to the right atrium, where it is connected to the kidneys, liver, intestines and other organs “Tian Lu, deputy chief physician, said that he arranged a CT examination of the inferior vena cava for Aunt Qian. The result of the examination showed that Aunt Qian’s inferior vena cava had a tumor the size of a ping-pong ball near the kidney! Combined with Aunt Qian’s condition, the vascular surgery expert team considered that she was suffering from a very rare primary inferior vena cava leiomyosarcoma, which compressed the nerve and caused low back pain.

Primary inferior vena cava leiomyosarcoma is a type of leiomyosarcoma, a very rare soft tissue sarcoma that is basically malignant. “In layman’s terms, it means that there is a tumor in the blood vessel wall, it can also be said to be ‘vascular cancer’. Everyone has heard of gastric cancer and lung cancer, but almost never of vascular cancer, and there are no more than 500 reports in the global literature. Example.” said Shang Tao, deputy chief physician of the vascular surgeon.

Currently, surgical resection is the most mainstream treatment method for primary inferior vena cava leiomyosarcoma, but due to the large blood flow of the inferior vena cava and the Multiple organs, the operation is very difficult, and it is very likely that an autologous kidney transplant will be performed during the operation (if the tumor seriously invades the kidney, the kidney needs to be removed to complete the removal of the tumor.tissue, and then transplanted back). More importantly, inferior vena cava leiomyosarcoma is easy to metastasize. Once multiple metastases occur, there may be no chance for treatment.

The team of vascular surgery experts arranged a PET-CT examination for Aunt Qian as soon as possible. The good news is that Aunt Qian’s tumor did not metastasize. Therefore, Vascular Surgery invited Hepatobiliary and Pancreatic Surgery, Urology, Nephrology Center, Cardiovascular Surgery, Medical Oncology, Anesthesiology, Blood Transfusion and other disciplines for consultation (MDT). The expert team discussed the possible situations during the operation in detail, and prepared the corresponding plan, and finally formulated the most suitable operation plan.

Resected tumor

After completing all preparations, Chief Physician Zhang Hongkun, Director of Vascular Surgery, Deputy Chief Physician Tian Lu, and Deputy Chief Physician Shang Tao performed surgery on Aunt Qian, and a multidisciplinary team of experts was also ready to work together for money. Auntie escort. The surgical expert team found that although Aunt Qian’s tumor had grown out of the blood vessel wall and destroyed surrounding tissues, it was fortunate that it did not invade other organs, so they carefully removed the tumor, performed lymph node dissection, and reconstructed this part of the lower cavity. venous blood vessels.

Expert Alert

Be alert for the following symptoms

“The vascular system is the tissue and organ with the lowest incidence of malignant tumors in the human body. Although primary inferior vena cava leiomyosarcoma is very rare, it accounts for the majority of malignant tumors of the vascular system.

strong>At present, the cause of the disease is unknown, it is common in women aged 50-60 years, and it mostly occurs near the kidneys.” said Zhang Hongkun, chief physician of the Department of Vascular Surgery.

Since this disease is relatively rare, most primary hospitals may not understand it, and it is difficult to treat patients with multiple metastases throughout the body. Moreover, the inferior vena cava, as the most important large vein in the human body, has huge blood flow and very thin blood vessel wall. Once it is torn, it will cause fatal hemorrhage, and the risk of surgery is too great. Strong hospital for surgery.

The Department of Vascular Surgery of the First Hospital of Zhejiang University accepts less than 10 cases per year. If there is no metastasis, the prognosis is better after surgical resection and later radiotherapy and chemotherapy.

Experts say this type of cancer is easily overlooked, and if you have unexplained low back pain, swelling of the lower extremities, etc., it is recommended to seek medical screening as soon as possible.