title: Cervical cord compression due to atypical primary neuroectodermal tumor (PNET): one-stage removal and combined cervical spine stabilization. Case report.
abstract: BACKGROUND
  The neuroectodermal tumor of bone constitutes a recently isolated neoplasm, which morphologically resembles the peripheral neuroepithelioma of soft tissue. The diagnosis is made by excluding readily classified small round cell neoplasms and then demonstrating the neural origin of the tumor by means of ultrastructural or immunocytochemical studies.
  
  
  METHODS
  We report a case of a primary neuroectodermal tumor (PNET) with atypical findings (primary cervical location, massive vertebral body infiltration and isolated neurological symptomatology). Total tumor removal was achieved by means of a one-stage three-level laminectomy (partial C5, total C6-C7), C6 somatectomy, and combined anterior and posterior cervical spinal instrumentation and fusion.
  
  
  CONCLUSIONS
  Our case presents three peculiar features: 1) isolated myelopathic symptomatology (first case described); 2) primary isolated massive vertebral cervical involvement with intraspinal epidural extension (first case described); 3) one-stage tumor resection, fusion and instrumentation. Since radiation therapy causes tumor shrinkage but is not curative, radical removal is mandatory even with complex instrumentation procedures.
authors.affiliation: Divisione di Neurochirurgia, Università Cattolica, Roma, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Visocchi
authors.forename: B
authors.initials: B
authors.lastname: Cioni
authors.forename: M
authors.initials: M
authors.lastname: Meglio
authors.forename: T
authors.initials: T
authors.lastname: Nizegorodcew
authors.forename: M
authors.initials: M
authors.lastname: Moschini
authors.forename: A
authors.initials: A
authors.lastname: Ieraci
mesh_terms: D002574:Cervical Vertebrae / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D018242:Neuroectodermal Tumors, Primitive / Q000150:complications* / Q000601:surgery; D013117:Spinal Cord Compression / Q000209:etiology* / Q000473:pathology