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Berkeley R, Andrei V, Saifuddin A. The rare primary bone sarcomas: imaging-pathological correlation. Skeletal Radiol 2021; 50:1491-1511. [PMID: 33410967 DOI: 10.1007/s00256-020-03692-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 02/02/2023]
Abstract
Rare primary bone sarcomas are challenging entities both radiologically and pathologically. These include the diagnoses of spindle cell sarcoma (leiomyosarcoma, fibrosarcoma, synovial sarcoma, and malignant peripheral nerve sheath tumor), pleomorphic liposarcoma, and undifferentiated pleomorphic sarcoma. The radiographic and cross-sectional imaging features of each of these tumors are presented, along with current key pathological concepts. Frequently non-specific, the radiological appearances must be correlated with all clinical and pathological information available to enable an accurate diagnosis.
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Affiliation(s)
- Rupert Berkeley
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.
| | - Vanghelita Andrei
- Department of Pathology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - Asif Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
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Liu W, Zhang S, Liu J, Shao Z. Intraosseous Malignant Peripheral Nerve Sheath Tumor of 2 Consecutive Lumbar Vertebrae: A Case Report and Literature Review. World Neurosurg 2019; 130:459-466. [PMID: 31349078 DOI: 10.1016/j.wneu.2019.07.117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/13/2019] [Accepted: 07/15/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Malignant peripheral nerve sheath tumor (MPNST), which refers to any malignant tumor that originates from peripheral nerve sheath cells, is rarely found in the spine. Primary intraosseous spinal MPNSTs are extremely uncommon; in fact, such an occurrence has been reported in a very limited number of cases hitherto. We report here one case of low-grade intraosseous MPNST in the lumbar vertebrae and review clinical research related to this rare tumor and modus operandi to its treatment. CASE DESCRIPTION A 51-year-old man suffering from lower back pain was initially diagnosed with lumbar tuberculosis. The intraoperative histopathologic examination, however, revealed that the occupying lesion was synovial sarcoma when surgeons intended to perform a debridement surgery of what was thought to be tuberculosis. The operation was therefore suspended. Two months later, the patient was referred to our institution. The pathologic sections were reexamined. Its results refuted the earlier thought of being synovial sarcoma, and a final diagnosis of MPNST was made. In addition, preoperative examination revealed that the tumor had advanced rapidly to the adjacent inferior vena cava and pedicle, which ruled out the possibility of performing a total en bloc spondylectomy. Therefore, a marginal resection for 2-level consecutive lumbar vertebrae was performed successfully via an anterior-posterior combined approach. No serious complications were detected at 18-month follow-up. CONCLUSIONS Preoperative biopsy is of great importance for the diagnosis of spinal tumors. Marginal resection of a complicated intraosseous spine MPNST via an anterior-posterior combined approach, despite being technically challenging, resulted in good survival and functional outcomes.
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Affiliation(s)
- Weijian Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Shuo Zhang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Jianxiang Liu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Zengwu Shao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
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Candanedo-Gonzalez F, Ortiz-Arce CS, Rosales-Perez S, Remirez-Castellanos AL, Cordova-Uscanga C, Gamboa-Dominguez A. Immunohistochemical features of giant cell ependymoma of the filum terminale with unusual clinical and radiological presentation. Diagn Pathol 2017; 12:7. [PMID: 28088216 PMCID: PMC5237534 DOI: 10.1186/s13000-016-0595-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 12/23/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Giant cell ependymoma of the filum terminale is a rare variant, generally manifested as a well-circunscribed intradural mass with an indolent biological behavior. CASE PRESENTATION We describe the case of a 48-year-old Mexican female who non-relevant past medical history, that developed a GCE of the filum terminale. Magnetic resonance imaging and computed tomography revealed the presence of an intra-axial tumor extending from L3 to L5 with extra-medullary invasion. Therefore the tumor was considered unresectable and only incisional biopsy was obtained, establishing the tentative diagnosis of a poorly differentiated neoplasia. A second evaluation of the case revealed the presence of numerous non-cohesive pleomorphic giant cells with intranuclear inclusions and broad eosinophilic cytoplasm, alternating with intermediate size cells with round, hyperchromatic nuclei and forming a perivascular pseudo-rosettes pattern. The ependymal phenotype was supported by light microscopy and corroborated by immunohistochemistry analysis. The patient was subsequently treated with radiotherapy 54Gy. She is alive after a 27-month follow-up, with residual disease, difficulty ambulating and pain. CONCLUSIONS GCE of filum terminale may have an atypical clinical and radiological presentation, albeit with invasive characteristics and anaplasia on histologic analysis. However, its biological behavior is indolent and associated to longer survival. Due to the presence of giant cells, the differential diagnosis of other primary neoplasias at that site were considered, including paraganglioma, malignant peripheral nerve sheath tumors as well as metastatic malignant melanoma, adrenal carcinoma, thyroid gland carcinoma and urothelial carcinoma, that may all harbor giant cells.
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Affiliation(s)
- Fernando Candanedo-Gonzalez
- Department of Pathology, Hospital de Oncologia, Centro Medico Nacional Siglo XXI, IMSS, Av Cuauhtemoc #330, Col: Doctores CP, 06720, Mexico City, Mexico.
| | - Cindy Sharon Ortiz-Arce
- Department of Radiotherapy, Hospital de Oncologia Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | - Samuel Rosales-Perez
- Department of Radiotherapy, Hospital de Oncologia Centro Medico Nacional Siglo XXI, IMSS, Mexico City, Mexico
| | | | - Candelaria Cordova-Uscanga
- Department of Pathology, Hospital de Oncologia, Centro Medico Nacional Siglo XXI, IMSS, Av Cuauhtemoc #330, Col: Doctores CP, 06720, Mexico City, Mexico
| | - Armando Gamboa-Dominguez
- Department of Pathology, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Mexico City, Mexico
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Muthusamy S, Conway SA, Pitcher JD, Temple HT. Primary Intraosseous Malignant Peripheral Nerve Sheath Tumor of the Medial Cuneiform: A Case Report and Review of the Literature. J Foot Ankle Surg 2016; 56:129-134. [PMID: 27449524 DOI: 10.1053/j.jfas.2016.05.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Indexed: 02/03/2023]
Abstract
Peripheral nerve sheath tumors (benign and malignant) usually arise in the soft tissues and are unusual in bone. Intraosseous peripheral nerve sheath tumors are usually benign and constitute approximately 0.2% of all bone tumors. Intraosseous malignant peripheral nerve sheath tumors (MPNSTs) are uncommon and usually result from secondary invasion. Only a few cases of primary intraosseous MPNSTs have been reported in published studies, and these were localized mostly in the mandible (approximately 50%) or maxilla, spine, and, occasionally, in the appendicular skeleton. To the best of our knowledge, we report the first case of primary intraosseous MPNST involving a midtarsal bone (medial cuneiform). The patient was a 62-year-old female who presented with pain and tenderness but without swelling. Imaging revealed nonspecific findings, and the preoperative computed tomography-guided biopsy findings were consistent with MPNST. The patient was treated with neoadjuvant radiotherapy, followed by wide local excision and allograft reconstruction. At the final follow-up examination (24 months), the graft had been incorporated without evidence of local recurrence or distant disease. The patient with primary intraosseous MPNST of the medial cuneiform described in the present report presented with nonspecific clinical and radiologic findings. Thus, a high index of suspicion and histopathologic examination, including immunohistochemistry, are necessary for an accurate diagnosis.
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Affiliation(s)
- Saravanaraja Muthusamy
- Musculoskeletal Oncology Fellow, Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, FL.
| | - Sheila A Conway
- Associate Professor, Division of Musculoskeletal Oncology, Department of Orthopaedic Surgery, University of Miami Miller School of Medicine, Miami, FL
| | - J David Pitcher
- Chief, Department of Orthopedic Surgery, Miami Veterans Affairs Healthcare System, Miami, FL
| | - H Thomas Temple
- Senior Vice President, Translational Research and Economic Development, Nova Southeastern University, Fort Lauderdale, FL
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Malignant peripheral nerve sheath tumor in the cervical spine with multiple nevus cell nevi. J Orthop Sci 2016; 21:250-4. [PMID: 26740424 DOI: 10.1016/j.jos.2015.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 10/12/2014] [Accepted: 10/30/2014] [Indexed: 10/23/2022]
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6
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Malignant peripheral nerve sheath tumor of the forehead. J Craniofac Surg 2014; 26:316-8. [PMID: 25502700 DOI: 10.1097/scs.0000000000001203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Mattei TA, Teles AR, Mendel E. Modern surgical techniques for management of soft tissue sarcomas involving the spine: outcomes and complications. J Surg Oncol 2014; 111:580-6. [PMID: 25413665 DOI: 10.1002/jso.23805] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 07/29/2014] [Indexed: 01/10/2023]
Abstract
Several types of soft tissue sarcomas may locally extend to the spine. The best therapeutic strategy for such lesions strongly depends on the histological diagnosis. In this article the authors provide an up-to-date review of current guidelines regarding the management of soft tissue sarcomas involving the spine. Special attention is given to outcomes and complications of modern surgical series in order to highlight current challenges in the management of such lesions.
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Affiliation(s)
- Tobias A Mattei
- Department of Neurosurgery, The Brain & Spine Center, Invision Health, Buffalo, New York
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Malignant peripheral nerve sheath tumors of the spine: A SEER database analysis. J Clin Neurosci 2014; 21:1106-11. [DOI: 10.1016/j.jocn.2014.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Accepted: 01/13/2014] [Indexed: 12/26/2022]
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SUZUKI KAYO, YASUDA TAKETOSHI, HORI TAKESHI, WATANABE KENTA, KANAMORI MASAHIKO, KIMURA TOMOATSU. An intraosseous malignant peripheral nerve sheath tumor of the lumbar spine without neurofibromatosis: Case report and review of the literature. Oncol Lett 2014; 7:1965-1969. [PMID: 24932270 PMCID: PMC4049692 DOI: 10.3892/ol.2014.1987] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 03/04/2014] [Indexed: 11/08/2022] Open
Abstract
A malignant peripheral nerve sheath tumor (MPNST) is defined as any malignant tumor that develops or differentiates from cells in the peripheral nerve sheath. This tumor is commonly associated with neurofibromatosis type 1 (NF1) and previous radiotherapy treatment. Primary intraosseous MPNSTs are extremely rare and a case of the lumbar spine in a patient without NF1 is reported in the present study, with a review of the intraosseous MPNST literature. A 45-year-old female presented with a 1-month history of severe lower back pain and pain radiating to the left leg. A total en bloc spondylectomy of L4 was performed. The postoperative histopathological diagnosis was MPNST with deletion of NF1, confirmed by dual-color fluorescence in situ hybridization (FISH) analysis. The tumor recurred 1 month following the surgery. Although adjuvant chemotherapy was administered, the patient succumbed due to intramedullary dissemination and carcinomatous meningitis 8 months following the initial consultation. NF1 deletion by FISH analysis may be particularly useful in distinguishing MPNST from other high-grade malignancies with overlapping morphological features.
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Affiliation(s)
- KAYO SUZUKI
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama City, Toyoma 939-0194, Japan
| | - TAKETOSHI YASUDA
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama City, Toyoma 939-0194, Japan
| | - TAKESHI HORI
- Department of Orthopaedic Surgery, Iiyama Red Cross Hospital, Iiyama City, Nagano 389-2295, Japan
| | - KENTA WATANABE
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama City, Toyoma 939-0194, Japan
| | - MASAHIKO KANAMORI
- First Department of Human Science, Faculty of Medicine, University of Toyama, Toyama City, Toyoma 939-0194, Japan
| | - TOMOATSU KIMURA
- Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, Toyama City, Toyoma 939-0194, Japan
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Roopesh Kumar VR, Madhugiri VS, Sasidharan GM, Shankar Ganesh CV, Gundamaneni SK. Multifocal spinal malignant peripheral nerve sheath tumor in an immunocompromised individual: case report and review of literature. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 23 Suppl 2:236-41. [DOI: 10.1007/s00586-013-3103-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 11/05/2013] [Accepted: 11/06/2013] [Indexed: 11/28/2022]
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Patnaik A, Mishra SS, Senapati SB, Patra SK, Tripathy K, Burma S. Primary intraosseous malignant peripheral nerve sheath tumor of spine with a giant paraspinal and retrospinal subcutaneous extension. Surg Neurol Int 2012; 3:157. [PMID: 23372973 PMCID: PMC3551491 DOI: 10.4103/2152-7806.105096] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 10/23/2012] [Indexed: 11/13/2022] Open
Abstract
Background: According to World Health Organization (WHO) classification of tumors, malignant peripheral nerve sheath tumors (MPNST) encompass the tumors, which were previously termed as malignant schwannoma, neurogenic sarcoma, and neurofibrosarcoma. These are rare tumors constituting only 5% of all malignant soft tissue tumors. As per their name, they arise from the malignant proliferation of cells forming sheath of a nerve root. They cause spinal cord compression, secondary changes in the surrounding bone with variable amount of tumor tissue going into the paraspinal space. However, purely intraosseous origin of the MPNST with no visible connection with a nerve root or dura is rare and few cases have been described in the literature. Case Description: We present a primary intraosseous MPNST arising from the body of a thoracic spine with a minimal intraspinal component. However, there was a huge tumor part occupying the paraspinal and retrospinal region. The latter component was so large that it extended to lie just beneath the skin. The intraspinal component was confined to only one level. The giant extraspinal part was spanning multiple corresponding spinal level. We could not find such presentation in the literature. Conclusion: Gross total removal (GTR) followed by adjuvant chemo-radiotherapy is the optimal treatment for MPNST of spine. In case of multiple laminectomy or gross spinal instability, spinal instrumentation makes the treatment protocol complete.
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Affiliation(s)
- Ashis Patnaik
- Department of Neurosurgery, SCB Medical College and Hospital, Cuttack, Odisha, India
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Sasamori T, Hida K, Yano S, Aoyama T, Asano T, Kubota K, Ito M, Abumi K, Iwasaki Y, Saito H, Houkin K. Favorable outcome after radical resection and subsequent local irradiation of malignant peripheral nerve sheath tumor in the cervical spine. Neurol Med Chir (Tokyo) 2012; 52:670-4. [PMID: 23006884 DOI: 10.2176/nmc.52.670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 25-year-old man presented with malignant transformation to malignant peripheral nerve sheath tumor (MPNST) in the cervical spine associated with neurofibromatosis type 1. He presented with a 3-week history of rapidly increasing weakness and numbness in all four extremities. Magnetic resonance (MR) imaging of the cervical spine demonstrated a dumbbell-shaped tumor, which compressed the spinal cord at the C2-3 level. The tumor was excised, mainly within the spinal canal to decompress the spinal cord. The histological diagnosis was benign neurofibroma. Three months after surgery, he rapidly developed progressive tetraparesis and MR imaging revealed marked regrowth of an extradural mass into the spinal canal. At reoperation, the regrown mass in the spinal canal was totally excised. The histological diagnosis revealed MPNST. He underwent radiation therapy, with a total dose of 32 Gy, for approximately 3 weeks after the second surgery, but MR imaging showed tumor regrowth within the spinal canal, and his condition deteriorated. The decision was made to remove the tumor radically, including the involved facet and extradural lesion. Posterior fusion using a pedicle screw was performed one month later. He manifested no additional neurological deficits. He has been free of relapse for 46 months. Radical resection remains the most effective treatment for MPNST, although complete removal with a clear tumor margin is often impossible in practice.
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Affiliation(s)
- Toru Sasamori
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan
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Zhu B, Liu X, Liu Z, Yang S, Liao HI, Jiang L, Wei F. Malignant peripheral nerve sheath tumours of the spine: clinical manifestations, classification, treatment, and prognostic factors. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2011; 21:897-904. [PMID: 22139051 DOI: 10.1007/s00586-011-2093-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2011] [Revised: 10/12/2011] [Accepted: 11/18/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND AND OBJECTIVES To summarise our experience treating patients with spinal malignant peripheral nerve sheath tumours (MPNSTs). METHODS We retrospectively reviewed the records of patients diagnosed with spinal MPNSTs who received surgical treatment from January 1998 to December 2009. RESULTS Postoperative follow-up data were available for 14/16 patients with spinal MPNSTs (7 men, 7 women; median age = 44 years [range: 23-68 years]). Eight of 14 (57.1%) patients had primary and 6/14 (42.9%) recurrent MPNSTs. A total of 12/14 (85.7%) patients underwent total tumour resection, whereas 2/14 (14.3%) patients underwent subtotal tumour resection. Malignancies were graded low in 4 (28.6%) and high in 10 (71.1%) cases. A total of 12/14 (85.7%) patients experienced tumour recurrence and 10/14 (71.4%) patients died during the course of follow-up. The 0.5- 1-, 3-, and 5-year survival rates were 64.3, 48.2, 32.1, and 21.4%, respectively. Overall survival was significantly associated with tumour malignant degree (P = 0.012). CONCLUSION Diagnosis of spinal MPNSTs should be made with reference to clinical, radiological, and pathological findings. Surgical resection is the best available option for treating spinal MPNST; however, postoperative prognosis is poor.
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Affiliation(s)
- Bin Zhu
- Department of Orthopaedics, Peking University Third Hospital, No 49. North Garden Street, HaiDian District, Beijing 100191, People's Republic of China
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Park SC, Chung SK, Choe G, Kim HJ. Spinal intraosseous schwannoma : a case report and review. J Korean Neurosurg Soc 2009; 46:403-8. [PMID: 19893734 DOI: 10.3340/jkns.2009.46.4.403] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2009] [Revised: 08/13/2009] [Accepted: 10/01/2009] [Indexed: 12/22/2022] Open
Abstract
A case of spinal intraosseous schwannoma (SIS) in the lumbar vertebra is reported. Clinical and radiologic characteristics of 16 reported cases of SIS were reviewed. SIS can be a rare differential diagnosis for intraosseous tumors.
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Affiliation(s)
- Seong-Cheol Park
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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An intraosseous malignant peripheral nerve sheath tumor of the cervical spine: a case report and review of the literature. Spine (Phila Pa 1976) 2008; 33:E712-6. [PMID: 18758353 DOI: 10.1097/brs.0b013e31817e6995] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Case description. OBJECTIVES To report a rare case of intraosseous malignant peripheral nerve sheath tumors (MPNST), and review the pertinent medical literature. SUMMARY OF BACKGROUND DATA The spinal MPNST that develops from spinal nerve roots and secondary bony erosion is well-known entity. However, primary intraosseous MPNSTs of the spine are extremely rare. METHODS A 41-year-old male presented with a 1-month history of radiating pain to his right shoulder and arm. Magnetic resonance images showed a large extradural mass extending from C6 to T1 with destruction of the posterior elements of C6, C7, and T1. Complete excision of the tumor and posterior stabilization were performed through a posterior approach. The tumor was noted to originate from the posterior element of C7. RESULTS The histopathology was diagnostic for a MPNST. Adjuvant chemotherapy was administered after surgery. The patient remained symptom-free for 30 months after surgery without local recurrence or metastasis. CONCLUSION We report an intraosseous MPNST of the cervical spine. Complete surgical excision and adjuvant chemotherapy resulted in a good functional outcome. MPNST should be added to the differential diagnosis of primary bone tumors causing spinal cord compression.
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Affiliation(s)
- Michael P Steinmetz
- The Cleveland Clinic Spine Institute, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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