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Sacral intraspinal extradural primitive neuroectodermal tumor
Affiliation:1. Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA;2. Icelandic Heart Association, Kopavogur, Iceland;3. Division of Epidemiology, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA;4. Division of Rheumatology, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA;5. Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, College of Medicine, Mayo Clinic, Rochester, MN, USA;6. Department of Radiology, Beijing Ji Shui Tan Hospital, Beijing, China;7. Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA;8. Department of Radiological Sciences, University of California, Irvine, Irvine, CA, USA;9. University of Iceland, Reykjavik, Iceland;10. Intramural Research Program, National Institute on Aging, Bethesda, MD, USA
Abstract:Background contextIntraspinal primitive neuroectodermal tumors (PNETs) are an exceedingly rare entity. A recent literature research revealed 28 cases reported. Only a few tumors in the literature were extradural in location, in the cervical and thoracic spine. The average survival after combination treatment including chemotherapy, radiation, and surgical resection is 20 months for the cases reported in the literature.PurposeWe report a case of a patient with sciatica and cauda equine–like symptoms.Study designCase report.MethodsUrgent sacral decompression and resection of the tumor was performed with rapid pain relief for the patient.ResultsHistology revealed a sacral extradural small blue-cell tumor, consistent with ES/PNET family tumors. An oncological workup revealed that the tumor presentation was metastatic with pulmonary and abdominal nodules. The patient underwent combination chemotherapy with vincristine, doxorubicin, and cyclophosphamide with mesna for 4 months.ConclusionsThe patient was without disease after excision, two courses of 4-month chemotherapy, and one course of 5-week radiation to the sacrum at 2 years.
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