Primary vertebral tumor of axis: A clinical and surgical challenge.

Autor: Hevia Rodríguez P; Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, Gipuzkoa, España. Electronic address: pelahevia@gmail.com., Andermatten J; Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, Gipuzkoa, España., Elúa Pinín A; Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, Gipuzkoa, España., Moreno Moya P; Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, Gipuzkoa, España., Samprón N; Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, Gipuzkoa, España., Úrculo Bareño E; Servicio de Neurocirugía, Hospital Universitario Donostia, Donostia, Gipuzkoa, España.
Jazyk: English; Spanish; Castilian
Zdroj: Neurocirugia (English Edition) [Neurocirugia (Astur : Engl Ed)] 2020 Oct 13. Date of Electronic Publication: 2020 Oct 13.
DOI: 10.1016/j.neucir.2020.08.004
Abstrakt: We report the case of a 17-year-old male presented to the emergency department with a six weeks history of neck pain and no neurogical deficit. Computed tomography and magnetic resonance imaging revealed an expansile lesion in the axis, with soft tissue and spinal cavity invasion, without mielopathy signs. Tomography-guided mass biopsy was taken. Waiting for histopathologic results, the pacient developed acute tetraparesis and sphincter incompetence. Magnetic resonance revealed that the bone mass had grown with epidural compromise, mielopathy and new vertebral lesions. Medular decompression with laminectomy, excision of the posterior elements of axis with the involved soft tissue mass and occipito-cervical fixation was performed. Neurological recovery was complete. Inmunochemistry revealed an Ewing Sarcoma. Chemoteraphy treatment was given, with partial response. Primary Ewing sarcoma of atlas-axis is a rare entity with poor prognosis. Multidisciplinary approach treatment is needed, with a total surgical resection if it is possible, a real challenge for the surgeon.
(Copyright © 2020 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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