A rare case of extradural Ewing sarcoma of the cervical spine in a 9-year-old boy

Abstract

Pediatric embryonal tumors have a rare occurrence in the peripheral nervous system. A more aberrant location is the extradural space, with only 25 cases being reported in literature. The seemingly innocuous symptoms can often be misleading as a sprain, and in our country, where tuberculosis is endemic, it can even be perceived as Pott’s spine, and therefore, leads to a delayed intervention for these rapidly progressive malignancies. We report the case of a 9-year-old boy whose symptoms started with a dull neck pain that was ignored for 6 months as a neck sprain. X-ray of his cervical spine showed only subtle loss of cervical lordosis, a finding that was missed. Eventually, he developed weakness of the right upper and lower limbs and was referred to our hospital. Magnetic resonance imaging revealed a large lobulated extradural lesion extending from C1-D3 level of neoplastic etiology. Postlaminectomy, the histopathology was consistent with primitive embryonal tumor. The patient was immediately started on an intensive chemotherapy regimen and is currently in the consolidation phase.

Keywords

• cervical spine
• embryonal tumor
• ewing sarcoma
• extradural