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.
Song
Xianyuan
X
Department of Pathology, SUNY Downstate Medical Center, Brooklyn, New York 11203, USA.
Choi
Jai
J
Rao
Chandrakant
C
Nallu
Sagarika
S
Nicastri
Anthony D
AD
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