Primary lumbosacral Wilms tumour associated with occult spinal dysraphism

A 4-year-old child presenting with sudden-onset paraplegia and a sacral tumour in association with spina bifida occulta is reported. There were no stigmata of spinal dysraphism at birth. Imaging studies confirmed a sacral tumour with extradural extension up to T10 and spinal dysraphism. The histological features of the extradural and sacral components of the tumour were consistent with a Wilms tumour. The differential diagnosis included a primary sacral teratoma containing Wilms tumour elements or a primary extrarenal Wilms tumour arising in association with a spinal dysraphism. There was no clinical response to chemotherapy or radiotherapy.

An unusual presentation of solitary fibrous tumor

STUDY DESIGN

Case report of a lumbar extradural solitary fibrous tumor.

OBJECTIVE

To describe the clinical manifestations and successful treatment of a patient with solitary fibrous tumor of the lumbar spine.

SUMMARY OF BACKGROUND DATA

Solitary fibrous tumor usually occurs on the pleura but has been described in a growing number of sites. Although this is the first case in a lumbar extradural location, clinicians should be aware of the many guises in which this entity appears. Most cases are benign and cure is effected by surgical extirpation.

METHODS

The diagnosis, treatment, and outcome of a patient with a lumbar extradural solitary fibrous tumor are reviewed.

RESULTS

A patient showing signs of myeloradiculopathy was found, by means of magnetic resonance imaging, to have an intensely enhancing extradural lesion in the region of L1. Excision biopsy revealed features of a solitary fibrous tumor. The patient made a rapid, complete recovery.

CONCLUSIONS

Solitary fibrous tumor has protean clinical manifestations and should be be considered in the differential diagnosis of intraspinal enhancing lesions on either side of the dura.