Md Neshar Ansari1, Anuj Gupta2, Dileep Kumar Jain3, Deepshikha Rana4. 1. Department of Orthopedics, Hind Institute of Medical Sciences, Lucknow, India. 2. Department of Spine Surgery, Max Superspeciality Hospital, Ghaziabad, India. anuj.toto123@gmail.com. 3. Department of Pathology, Hind Institute of Medical Sciences, Lucknow, India. 4. Department of Pathology, University College of Medical Sciences, New Delhi, India.
Abstract
INTRODUCTION: Ewing's sarcoma is a Primary Neuroectodermal Tumour (PNET) commonly affecting appendicular skeleton. The involvement of axial skeleton is very rare and that too of cervical spine is rarest. We present a case of Ewing's sarcoma involving cervical spine managed surgically, and its outcome. CASE PRESENTATION: A 26-year-old male presented with 3-month history of neck pain and progressive motor weakness for 1 week. After clinical evaluation of sign and symptoms, MRI of cervical spine revealed a posterior neck mass over C2, C3 and C4. Because of mass effect and spinal cord compression, early surgical intervention was deemed necessary to stop progression of neurological deficit and make tissue diagnosis of lesion. On histopathological examination diagnosis of Ewing sarcoma was made. PET-CT showed C2 and C3 as primary site of involvement with no other site of involvement. DISCUSSION: The Ewing's Sarcoma of the cervical spine is a rare occurrence and usually present in late and advanced stage. High index of suspicion should be present to make early diagnosis and prevent complications.
INTRODUCTION: Ewing's sarcoma is a Primary Neuroectodermal Tumour (PNET) commonly affecting appendicular skeleton. The involvement of axial skeleton is very rare and that too of cervical spine is rarest. We present a case of Ewing's sarcoma involving cervical spine managed surgically, and its outcome. CASE PRESENTATION: A 26-year-old male presented with 3-month history of neck pain and progressive motor weakness for 1 week. After clinical evaluation of sign and symptoms, MRI of cervical spine revealed a posterior neck mass over C2, C3 and C4. Because of mass effect and spinal cord compression, early surgical intervention was deemed necessary to stop progression of neurological deficit and make tissue diagnosis of lesion. On histopathological examination diagnosis of Ewing sarcoma was made. PET-CT showed C2 and C3 as primary site of involvement with no other site of involvement. DISCUSSION: The Ewing's Sarcoma of the cervical spine is a rare occurrence and usually present in late and advanced stage. High index of suspicion should be present to make early diagnosis and prevent complications.
Authors: Raphaële Charest-Morin; Michael S Dirks; Shreyaskumar Patel; Stefano Boriani; Alessandro Luzzati; Michael G Fehlings; Charles G Fisher; Mark B Dekutoski; Richard Williams; Nasir A Quraishi; Ziya L Gokaslan; Chetan Bettegowda; Niccole M Germscheid; Peter P Varga; Laurence D Rhines Journal: Spine (Phila Pa 1976) Date: 2018-05-01 Impact factor: 3.468