Primary Ewing sarcoma of lumbar spine with massive intraspinal extension.
Primary vertebral Ewing sarcoma-primitive neuroectodermal tumor is uncommon. Although epidural extension has been seen in such tumors, cases with massive intraspinal involvement are decidedly rare. Here we present the case of a 4-year-old girl with back pain and difficulty walking. Magnetic resonance imaging showed a mass filling the spinal canal from T(11) to the L(3)/L(4) levels. Vertebral involvement with extension into the paraspinal soft tissue through neural foramina was seen. Histologically, a small-blue-cell tumor with strong membranous CD99 reactivity was noted. Molecular analysis revealed translocation t(11;22)(q24;q12), thus confirming the diagnosis of Ewing sarcoma-primitive neuroectodermal tumor. Our case emphasizes that vertebral Ewing sarcoma-primitive neuroectodermal tumor may present with massive intraspinal extension and should be included in the differential diagnosis of intraspinal lesions.
Department of Pathology, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA.
Xianyuan
X
Song
Jai
J
Choi
Chandrakant
C
Rao
Sagarika
S
Nallu
Anthony D
AD
Nicastri
D000071443:12E7 Antigen; D015703:Antigens, CD / Q000032:analysis / Q000378:metabolism; D001416:Back Pain / Q000209:etiology; D014408:Biomarkers, Tumor / Q000032:analysis / Q000378:metabolism; D015815:Cell Adhesion Molecules / Q000032:analysis / Q000378:metabolism; D002675:Child, Preschool; D002880:Chromosomes, Human, Pair 11 / Q000235:genetics; D002892:Chromosomes, Human, Pair 22 / Q000235:genetics; D003937:Diagnosis, Differential; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology; D006801:Humans; D007866:Leg / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D020335:Paraparesis / Q000209:etiology; D012512:Sarcoma, Ewing / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D013115:Spinal Canal / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D014178:Translocation, Genetic / Q000235:genetics
D000071443:12E7 Antigen; D015703:Antigens, CD; D014408:Biomarkers, Tumor; C061828:CD99 protein, human; D015815:Cell Adhesion Molecules