title: Multifocal spinal malignant peripheral nerve sheath tumor in an immunocompromised individual: case report and review of literature.
abstract: OBJECTIVE
  Primary intraosseous spinal malignant peripheral nerve sheath tumor (MPNST) is exceedingly rare. MPNST with multifocal origin has been described to occur in the extremities. Such a lesion has not been described to occur in the spine. We describe a case of multifocal spinal MPNST and to review the literature relevant to this rare entity and its management.
  
  
  METHODS
  A 40-year-old immunodeficient patient presented with rapidly progressive paraparesis and mid back ache.
  
  
  RESULTS
  Despite aggressive surgical decompression, he developed multiple metastases 3 months after surgery. However, he remained stable for 1 year without any adjuvant therapy. Presently, he has received palliative radiotherapy for spinal recurrence and cerebral metastasis.
  
  
  CONCLUSIONS
  Multifocal spinal MPNST is a rare lesion. In this instance, the multifocality of the disease and its odd location could be attributed to the immunodeficiency state. The prolonged survival could be due to an improvement in his immune status due to HAART.
authors.affiliation: Department of Neurosurgery, Jawaharlal Institute of Post-graduate Medical Education and Research (JIPMER), 2nd Floor, Super Specialty Block, Pondicherry, 605006, India, roops1975@gmail.com.
authors.forename: V R
authors.initials: VR
authors.lastname: Roopesh Kumar
authors.forename: Venkatesh S
authors.initials: VS
authors.lastname: Madhugiri
authors.forename: Gopalakrishnan M
authors.initials: GM
authors.lastname: Sasidharan
authors.forename: C V
authors.initials: CV
authors.lastname: Shankar Ganesh
authors.forename: Sudheer Kumar
authors.initials: SK
authors.lastname: Gundamaneni
mesh_terms: D000328:Adult; D001416:Back Pain / Q000209:etiology; D001932:Brain Neoplasms / Q000556:secondary; D019299:Decompression, Surgical; D015658:HIV Infections; D006801:Humans; D016867:Immunocompromised Host; D008297:Male; D018317:Nerve Sheath Neoplasms / Q000473:pathology* / Q000556:secondary / Q000601:surgery; D020335:Paraparesis / Q000209:etiology; D035583:Rare Diseases / Q000473:pathology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000473:pathology* / Q000601:surgery; D013899:Thoracic Neoplasms / Q000473:pathology* / Q000601:surgery