[Infected cervical epidural Ewing's sarcoma (case report)].
BACKGROUND
Ewing's sarcoma is a relatively rare osseous malignant tumour. The age of onset is generally in the youth. Epidural localisation of the malignant osseous tumour Ewing's sarcoma is exceptional. Only 29 cases were reported in surgical literature including only one infected case.


METHODS
We report a case of a 24 years old patient who displayed a complete flaccid tétraplégia with T1 sensitive level. Spinal cord MRI documented a cervical posterior epidural process with peripheric gadolinium enhancement. Patient was operated in emergency. A C6 and C7 laminectomy allowed complete tumour resection with its purulent intratumoural collection revealed during the operation. A total tumour removal was performed. The immediate postsurgical evolution was remarkable, with a quasi complete recovery in the upper limbs.


CONCLUSIONS
Firstly described by James Ewing in 1921, the spinal epidural locations of the Ewing's sarcoma are rare without specific clinical signs generally presenting as a radiculo-medullary compression. Our case is the second infected epidural Ewing sarcoma reported in the literature. However the cause remains unexplained. For this spinal epidural extraosseous tumour, X-ray radiography failed to show any osseous lesions. On MRI, the usually found aspect is a T1 and T2 isosignal with gadolinium enhancement.


CONCLUSIONS
Through our observation, we underlined the scarcity of this pathology in the cervical epidural localization and the association with infection. We also emphasized on the complete removal, in order to give the best functional and vital outcome.
Lakhdar
F
F
Service de neurochirurgie, hôpital Ibn-Sina, Rabat, Morocco. faycal_f1@hotmail.com
Gana
R
R
Laghmari
M
M
Moufid
F
F
Maaqili
R
R
Bellakhdar
F
F
D000328:Adult; D002574:Cervical Vertebrae; D003287:Contrast Media; D003937:Diagnosis, Differential; D015174:Epidural Neoplasms / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D012512:Sarcoma, Ewing / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery
D003287:Contrast Media; D019786:Gadolinium DTPA