CC BY-NC-ND 4.0 · Asian J Neurosurg 2021; 16(02): 276-280
DOI: 10.4103/ajns.AJNS_340_20
Original Article

Primary spinal extradural extraosseous primitive neuroectodermal tumor/Ewing's sarcoma: A critical analysis and review

Akshay Patil
Department of Neurourgery, JNMC and AVBRH, Wardha, Maharashtra
,
Prasheelkumar Gupta
1   Department of Neurosurgery, MGIMS, Sevagram, Maharashtra
,
Sandeep Iratwar
Department of Neurourgery, JNMC and AVBRH, Wardha, Maharashtra
› Author Affiliations

Primary spinal extradural Ewing's sarcoma/primitive neuroectodermal tumor (PNET) is rare malignant tumor of childhood and early adulthood. The World Health Organization classifies PNET as an undifferentiated round cell tumor arising from primitive neuroepithelial cell. It can be central or peripheral PNET depending on site of presentation. Usually, the presenting symptoms are chronic back pain and myelopathy. Overall prognosis and survival are dismal in spite of total surgical resection and adjuvant therapy. Because of the rarity and malignant behavior, definite management of spinal PNET has never been described. After review of medical record at Acharaya Vinoba Bhave Rural Hospital, Sawangi, India, we identified four patients of spinal PNET and were included in our study. Age at diagnosis ranging from 15 to 26 years old with mean age of 20 years old. All four cases were epidural in location, two of which were of Askin type tumor with spinal cord compression. Rural population with low literacy and financial constraints were the key reasons of late presentations at our hospital. Counseling and proper education regarding the disease are a must for early case detection and early treatment of those living in rural areas and suffers from financial constraints. Due to rarity of the disease and its poor prognosis, a well-organized multicentric controlled trial is required to formulate a standard guidelines in the management of this disease.

Financial support and sponsorship

Nil.




Publication History

Received: 12 July 2020

Accepted: 15 February 2020

Article published online:
16 August 2022

© 2021. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Ellis JA, Rothrock RJ, Moise G, McCormick PC 2nd, Tanji K, Canoll P, et al. Primitive neuroectodermal tumors of the spine: A comprehensive review with illustrative clinical cases. Neurosurg Focus 2011;30: E1.
  • 2 Ozdemir N, Usta G, Minoglu M, Erbay AM, Bezircioglu H, Tunakan M. Primary primitive neuroectodermal tumor of the lumbar extradural space. J Neurosurg Pediatr 2008;2:215-21.
  • 3 Engelhard HH, Villano JL, Porter KR, Stewart AK, Barua M, Barker FG, et al. Clinical presentation, histology, and treatment in 430 patients with primary tumors of the spinal cord, spinal meninges, or cauda equina. J Neurosurg Spine 2010;13:67-77.
  • 4 Saeedinia S, Nouri M, Alimohammadi M, Moradi H, Amirjamshidi A. Primary spinal extradural Ewing's sarcoma (primitive neuroectodermal tumor): Report of a case and meta-analysis of the reported cases in the literature. Surg Neurol Int 2012;3:55.
  • 5 Duan XH, Ban XH, Liu B, Zhong XM, Guo RM, Zhang F, et al. Intraspinal primitive neuroectodermal tumor: Imaging findings in six cases. Eur J Radiol 2011;80:426-31.
  • 6 Llombart-Bosch A, Machado I, Navarro S, Bertoni F, Bacchini P, Alberghini M, et al. Histological heterogeneity of Ewing's sarcoma/PNET: An immunohistochemical analysis of 415 genetically confirmed cases with clinical support. Virchows Arch 2009;455:397-411.
  • 7 Thomas AC, Rajashekharan R. A rare case of dumbbell-shaped primary intraspinal peripheral primitive neuroectodermal tumor involving thoracic spinal epidural space. Asian J Neurosurg 2018;13:1216-8.
  • 8 Eghbal K, Dehghanian AR, Ghaffarpasand F. Lumbosacral epidural primitive neuroectodermal tumor (PNET): Case report and literature review. Turk Neurosurg 2018;28:1005-8.
  • 9 Kutty RK, Peethambaran A, Sunilkumar BS, Balachandran Nair KG, Korde P, Jain SK. Ewing sarcoma of the cervical epidural space presenting with tetraplegia: Case report and review of literature. World Neurosurg 2017;107:1046.e9-15.
  • 10 Weber DC, Rutz HP, Lomax AJ, Schneider U, Lombriser N, Zenhausern R, et al. First spinal axis segment irradiation with spot-scanning proton beam delivered in the treatment of a lumbar primitive neuroectodermal tumour. Case report and review of the literature. Clin Oncol (R Coll Radiol) 2004;16:326-31.
  • 11 Albrecht CF, Weiss E, Schulz-Schaeffer WJ, Albrecht T, Fauser S, Wickboldt J, et al. Primary intraspinal primitive neuroectodermal tumor: Report of two cases and review of the literature. J Neurooncol 2003;61:113-20.
  • 12 Nasaka S, Gundeti S, Ganta RR, Arigela RS, Linga VG, Maddali LS. Impact of treatment protocol on outcome of localized Ewing's sarcoma. South Asian J Cancer 2016;5:194-5.
  • 13 Kumar R, Reddy SJ, Wani AA, Pal L. Primary spinal primitive neuroectodermal tumor: Case series and review of the literature. Pediatr Neurosurg 2007;43:1-6.
  • 14 Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, editors. WHO Classification of Tumours of the Central Nervous System. 4th ed., Vol. 1. Lyon: IARC; 2007.