A rare case of acute paraplegia: primary Ewing’s Sarcoma of dorsal spine

Authors

  • Yeshwant Kumar N. N. T. Department of General Surgery, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
  • V. T. T. Rajan Department of Neurosurgery, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/2349-2902.isj20181460

Keywords:

Ewing's sarcoma, Paraplegia, Primary spine tumor, Spinal cord compression

Abstract

Ewing's sarcoma is a primary bone malignancy with the highest incidence in the second decade of life. Although it mostly affects the metaphyseal region of long growing bones, involvement of spine is not very uncommon especially the sacrum. Non-sacral spinal Ewing's sarcoma is rarer and often mimics a benign condition before spreading extensively. They present with neurologic deficits due to spinal cord compression, but acute onset paraplegia has not been previously reported. A high index of clinical suspicion can clinch the diagnosis early in the course of the disease. A prompt intervention is required to keep neurological damage to a minimum, and a correct combination of surgery, chemotherapy, and radiotherapy is required for better long-term patient outcome. We report a 11-year-old female who presented with acute paraplegia and had an excellent postoperative outcome after radical excision of a C7-D2 Ewing's sarcoma.

References

Bacci G, Picci P, Gherlinzoni F, Capanna R, Calderoni P, Putti C, et al. Localized Ewing's sarcoma of bone: Ten years’ experience at the Instituto Ortopedico Rizzoli in 124 cases treated with multimodal therapy. Eur J Cancer Clin Oncol. 1985;21:163-73.

Bemporad JA, Sze G, Chaloupka JC, Duncan C. Pseudohemangioma of the vertebra: An unusual radiographic manifestation of primary Ewing's sarcoma. AJNR Am J Neuroradiol. 1999;20:1809-13.

Bruckner JD, Conrad EU., Spine. In: Simon MA, Springfield D, editors. Surgery for bone and soft-tissue tumours. Philadelphia: Lippincott-Raven; 1998:435-50.

Dini LI, Mendonça R, Gallo P. Primary Ewings sarcoma of the spine: Case report. Arq Neuropsiquiatr. 2006;64:654-9.

Ebb DH, Green DM, Shamberger RC, Tarbell NJ. Solid tumours of childhood. In: DeVita VT Jr, Hellman S, Rosenberg SA, editors. Cancer Principles and Practice of Oncology. Philadelphia: Lippincott; 2005:1919-23.

Estes DN, Magill HL, Thompson EI, Hayes FA. Primary Ewing's sarcoma: Follow-up with Ga-67 scintigraphy. Radiology. 1990;177:449-53.

Grubb MR, Currier BL, Pritchard DJ, Ebersold MJ. Primary Ewing's sarcoma of the spine. Spine (Phila Pa 1976) 1994;19:309-13.

Pilepich MV, Vietti TJ, Nesbit ME, Tefft M, Kissane J, Burgert O, et al. Ewing's sarcoma of the vertebral column. Int J Radiat Oncol Biol Phys. 1981;7:27- 31.

Gopalakrishnan CV, Shrivastava A, Easwer HV, Nair S. Primary Ewing's sarcoma of the spine presenting as acute paraplegia. J Pediatric Neurosci. 2012 Jan;7(1):64.

Sharafuddin MJ, Haddad FS, Hitchon PW, Haddad SF, el-Khoury GY. Treatment options in primary Ewing's sarcoma of the spine: Report of seven cases and review of the literature. Neurosurgery. 1992;30:610-8.

Widhe B, Widhe T. Initial symptoms and clinical features in osteosarcoma and Ewing sarcoma. J Bone Joint Surg Am. 2000;82:667-74.

Downloads

Published

2018-04-21

Issue

Section

Case Reports