Primary vertebral leiomyosarcoma masquerading as a nerve sheath tumour.
A 47-year-old woman presented with symptoms of low back pain and weakness in bilateral lower limbs. MRI of the spine revealed a mass arising from T11 vertebra involving neural foramina at bilateral T11-12 and right T10-11 levels with extension to the right paravertebral region. Suspecting a nerve sheath tumour, she underwent posterior spinal decompression, stabilisation and debulking, following which her neurological symptoms resolved. Histopathological and immunohistochemical evaluation revealed a leiomyosarcoma. A month later she developed sudden paraparesis and MRI revealed an increase in size of the tumour with cord compression and displacement. She underwent a repeat spinal decompression and debulking procedure after which she received adjuvant radiotherapy via volumetric modulated arc therapy, to a total dose of 45 Gy in 25 fractions over 5 weeks. MRI performed 2 months later revealed complete response and she is disease free for the past 5 months.
Department of Radiation Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India.
Irfan
I
Ahmad
Department of Radiodiagnosis, Gulati Imaging Institute, New Delhi, Delhi, India.
Nidhi
N
Goyal
Department of Radiation Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India.
Chandi Prasad
CP
Bhatt
Department of Radiation Oncology, Batra Hospital & Medical Research Centre, New Delhi, Delhi, India.
Kundan Singh
KS
Chufal
D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D017116:Low Back Pain / Q000209:etiology; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018317:Nerve Sheath Neoplasms / Q000175:diagnosis / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D013117:Spinal Cord Compression / Q000209:etiology; D013125:Spinal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D013904:Thoracic Vertebrae