Ewing's sarcoma presenting as a cervical intradural extramedullary tumor in a 42 year old: Report of a case

Abstract

The development of Ewing's sarcoma (ES) as an intradural, extramedullary cervical spinal cord tumor is uncommon. It is particularly rare in a middle-aged adult. We describe the clinical, pathological and genetic features in a 42 year old male with a 3 month history of arm weakness. MRI of the cervical spine with and without contrast revealed an intradural, extra-axial enhancing lesion involving the spinal canal from the foramen magnum to the level of C4. Partial surgical resection revealed a malignant neuroepithelial tumor. Genetic analysis identified a EWSRA-FLI1 (exon 7-exon 6) fusion, transcript suggesting classification as a Ewing's sarcoma/primitive neuroectodermal tumor. The case highlights the variability in the presentation of ES and value of genetic testing in atypical “blue cell” tumors. Keywords: Ewing's sarcoma, Cervical spinal cord, Adult, Genetics