Unusual Presentation of a Primary Ewing’s Sarcoma of the Spine with Paraplegia: A Case Reportusing RD01-RD03
Dr. Rajkumar Jayachandran Sundarapandian,
No.19, Kalai Nagar, First Street, Madurai, Tamil Nadu-625017, India.
Ewingâ€™s sarcoma is a primary malignancy of the bone affecting individuals in the second decade of life. Primary sarcomas of the spine are rare and the occurrence of Primary Ewingâ€™s sarcoma in the spine is very rare. Ewingâ€™s sarcoma occurring in the spine is divided into two types, Ewingâ€™s sarcoma of sacral spine which are very aggressive with poor prognosis and Ewingâ€™s sarcoma of the non sacral spine which is an extremely rare occurrence. Patient may present with neurological deficit when the tumour extends into the spinal canal causing spinal cord compression. Magnetic resonance imaging (MRI) is very sensitive in diagnosing the tumour and defining the extent of the tumour. Here we report an 18-year-old boy who presented with back pain and complete paraplegia of two months duration. The MRI gave a differential diagnosis of infective pathology due to the fluid collection in the paraspinal region, followed by primary malignancy as the second diagnosis. Patient underwent posterior spinal decompression and stabilization, and intaoperatively there was significant collection of pus whose culture showed no growth. The histopathology and immunohistochemistry studies confirmed the diagnosis of Ewingâ€™s sarcoma and patient was started on combination chemotherapy and radiotherapy.