Background. Ewing’s sarcoma is a bony highly malignant tumour, it occurs most frequently in the second decade of life. Ewing’s sarcoma is a rare affection, located usually in the pelvis, the femur, the humerus, the ribs, the mandible and clavicle, other location are rare especially in the spine. We report three cases of spinal Ewing’s sarcoma, two primary spine locations and one on young adult with unusual clinical presentation.
Cases presentation
Case 1. The first patient is a girl of 14 years old without past medical history. She presented initially two months before consultation a neck pain followed days after by a weakness of the left upper limb; the spine imaging performed objectified a destructive process of C2 with a spinal cord compression. The patient was operated beneficiating of a spinal cord decompression and a subtotal removal of the tumour. The pathologist’s results were in favour of Ewing’s sarcoma and the patient was oriented to oncology.
Case 2. The second patient is a man of 31 years old operated five years before he consulted for shoulder Ewing’s sarcoma followed by chemotherapy and radiotherapy, he presented two months before consultation a cauda equina syndrome. Spine MRI objectified a double location of an epidural tumour at T3-T4 and S1-S2 levels. The patient was operated beneficiating of subtotal removal of the tumour. The laboratory exam results were in favour of Ewing’s sarcoma and the patient was oriented to oncology.
Case 3. The third patient is a 6 years old boy who presented a 1 month history of low back pain followed by a rapidly deteriorating weakness of both lower limbs over a weak. On examination there was bilateral spastic paraplegia, hypoesthesia below the level of Th10 and a urinary retention. The MRI imaging revealed a lesion on the levels Th8, Th9 and Th10 vertebras involving the body, pedicle, lamina, and the transverse process on the left side with an epidural invasion compressing the spinal cord. The tumour was radically removed. Pathology report was in favour of Ewing’s sarcoma. Two weeks after surgery the patient was able to walk. He was referred for adjuvant systemic chemotherapy.
Conclusion. Ewing’s sarcoma is rare malignant tumour. The location in the spine exposes the patient to more complications because of the neurostructures compression. The surgical total removal followed by radio and chemotherapy is the only option with the best prognostic and guaranties an acceptable life quality.
Primary Ewing’s Sarcoma of the Spine in a Two-Year-Old Boy