Presentation
Patient with known history of pelvic bone Ewing sarcoma, presented with loss of sensation below the nipple line with loss of power in both lower limbs and urinary retention.
Patient Data
There are two extradural soft tissue masses, as follows :
- one seen at the level D3-D4 causing severe compression on the right posterolateral spinal cord, displacing the spinal cord anterolaterally to the left side, protruding through the right nerve foramina
- the other one is seen at the level D8 causing compression on the right posterolateral spinal cord and displacing the spinal cord anterolaterally to the left side, and protruding through the right nerve foramina
There are diffuse osseous lesions in the spine, that appear low intense on T1-weighted images and hyperintense on T2 weighted images, consistent with osseous metastases.
Case Discussion
The patient underwent radiotherapy and decompression surgery, his condition improved post-surgery. The Pathology confirmed metastases from the known pelvis Ewing sarcoma.
This is the pathology report: Diagnosis: T8 soft tissue mass; Biopsy: consistent with metastatic Ewing sarcoma. Note: The tumour cells are positive for CD99 and NKX2.2.
Spinal cord compression could be divided according to the location into epidural, dural, and intradural causes as follows:
- epidural lesions: epidural abscess or phlegmon, epidural haematoma and metastases
- dural lesions: epinal meningioma and spinal arachnoid cyst
- intradural lesions: nerve sheath tumour (spinal schwannoma or neurofibroma)
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