Primary spinal epidural extraosseous Ewing's Sarcoma with brachial plexus infiltration

Sarbesh Tiwari; Taruna Yadav; Jaya Pamnani; Kartikeya Shukla; Meenakshi Rao; Jaskaran Gosal; Pawan Garg; Pushpinder Khera

doi:10.4103/ajns.AJNS_138_20

Asian Journal of Neurosurgery, Table of Contents

CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(04): 1068-1071
DOI: 10.4103/ajns.AJNS_138_20

Case Report

Primary spinal epidural extraosseous Ewing's Sarcoma with brachial plexus infiltration

Authors

Sarbesh Tiwari

Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
Taruna Yadav

Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
Jaya Pamnani

Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
Kartikeya Shukla

Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
Meenakshi Rao

¹Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
Jaskaran Gosal

²Department of Neurosurgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan
Pawan Garg

Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan
Pushpinder Khera

Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, Rajasthan

Abstract

The Ewing's sarcoma family of tumors are aggressive malignant small round blue cell tumors of undifferentiated mesenchymal origin. Skeletal Ewing's sarcoma is a common entity that classically involves the diaphysis of the long bones, pelvis, ribs, and sacrum. Extraosseous Ewing's sarcoma (EES) is rare, most commonly presenting as a paravertebral mass lesion. Its manifestation as an anterior epidural mass lesion with extension along brachial plexus is an even rarer phenomenon. A 25-year-old male presented with neck stiffness and progressive weakness of the bilateral upper and lower limbs. Magnetic resonance imaging of the cervical spine revealed an anterior epidural mass lesion compressing the cervical cord and extending along the right brachial plexus, suggesting imaging differentials of EES and lymphoma. The patient underwent laminectomy with gross tumor resection, and histopathology confirmed a diagnosis of EES. EES should be kept in the differential diagnosis of anterior epidural mass lesions in young adults, specifically when the lesion shows extension along multiple neural foramina and nerve plexus.

Key-words:

Ewing's sarcoma family of tumors - Ewing's sarcoma - extraosseous Ewing's sarcoma - peripheral primitive neuroectodermal tumor

Full Text

References

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