title: Lumbosacral Epidural Primitive Neuroectodermal Tumor (PNET): Case Report and Literature Review.
abstract: The primitive neuroectodermal tumors (PNETs) of the spine are rare. They are usually intramedullary and reported in children. We herein report an epidural PNET of lumbosacral area presenting with the cauda equina syndrome in an adult. A 38-year-old woman presented to our emergency room with acute onset lower extremity weakness and urinary incontinence. Emergent magnetic resonance imaging revealed a mass lesion isointense on T1-weighted and heterogeneously hyperintense in T2-weighted images in the epidural lumbosacral area. The patient underwent emergent laminectomy of L1-L3 and total resection of the lesion. The patient"s neurological examination improved dramatically after the surgery and after 6-month of follow-up, she was neurologically intact. The histopathological and immunohistochemical evaluations revealed PNET. Epidural PNET of the spinal column, although rare, can present with an acute neurological deficit. Surgery remains the treatment of choice and immunohistochemistry is required for confirming the diagnosis.
authors.affiliation: Shiraz University of Medical Sciences, Department of Neurosurgery, Shiraz, Iran.
authors.forename: Keyvan
authors.initials: K
authors.lastname: Eghbal
authors.forename: Amir Reza
authors.initials: AR
authors.lastname: Dehghanian
authors.forename: Fariborz
authors.initials: F
authors.lastname: Ghaffarpasand
mesh_terms: D000328:Adult; D000077684:Cauda Equina Syndrome / Q000209:etiology; D004824:Epidural Space / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007796:Laminectomy / Q000379:methods; D008161:Lumbosacral Region / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D018242:Neuroectodermal Tumors, Primitive / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013120:Spinal Cord Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery