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Primary Ewing's Sarcoma of Spine, Its Management & Outcome: A Retrospective Analysis

Manish Jaiswal* , Somil Jaiswal* , Manish Jaiswal* , Pooja Jaiswal** , Chhitij Srivastava*** , Sunil Kumar Singh**** , Anil Chandra**** , Bal Krishna Ojha*****

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International Journal of Neurology and Neurosurgery 9(1):p 33-38, January - June 2017. | DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.9117.5

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Abstract

 Objective: PrimaryEwing’ Sarcoma (ES) of spine is rare entity but causes significant morbidity if not diagnosed in time and not managed properly, so the optimal management of primary Ewing’s Sarcoma spine should be analysed to improve the final outcome. Patients &Methods: We retrospectively analysed eight cases of spine ES who had been operated in last 8 years in one of the tertiary centre of northern India. Result: Male: female ratio was 7:1. Most common presenting symptoms was paraparesis in all 8 patients. Most common site of spine involvement was dorsal spine in all patients.MRI spine showed lobulated lesion well demarcated and enhancing, extending in paravertebral tissue in six out of eight cases.Histopathological examination of specimens after surgical decompression from all patients showed small blue round cell tumors, arranged in sheets. CD99 was positive in all the cases. One patient developed recurrence after 2 years of surgery and further lost follow up. 5 patients died (one immediate due to surgical complication, one early chemo-radiation phase due to neutropenia and subsequent septicemia & 3 patients at 9, 13 and 15 months of primary surgery. Only two out eight patients were recurrence free who had undergone chemo-radiation after surgery. Conclusion: Primary Ewing’s sarcoma of spine has poor outcome even after surgical decompression and chemo-radiation as multimodality management. Strict follow up is must for improving the outcome.

Keywords: Ewing’s Sarcoma Spine; CD99; Spinal Tumour; Round Cell Tumour

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.9117.5

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