Spondylectomy for Primary Ewing Lumbar Sarcoma in Children^[*]

Abstract

Primary Ewing sarcoma in the spine is very rare, and the treatment for it is multidisciplinary. There is no consensus regarding the optimal method of local control; however, en bloc resection is associated with an improvement in survival rates. The authors report a case of a 5-year-old girl who initially presented low back pain, and was diagnosed with Ewing sarcoma after being submitted to imaging studies by radiography, magnetic resonance and bone biopsy. A spondylectomy was performed in accordance with the Euro Ewing protocol. At the three-year follow-up, the patient had no restrictions regarding her daily activities, and there has been no evidence of recurrence to date.

Keywords

spinal neoplasms/surgery - Ewing sarcoma/surgery - lumbar vertebrae - osteosarcoma/surgery

• Referências

• 1 Maheshwari AV, Cheng EY. Ewing sarcoma family of tumors. J Am Acad Orthop Surg 2010; 18 (02) 94-107
• 2 Sewell MD, Tan KA, Quraishi NA, Preda C, Varga PP, Williams R. Systematic review of en bloc resection in the management of Ewing's sarcoma of the mobile spine with respect to local control and disease-free survival. Medicine (Baltimore) 2015; 94 (27) e1019
• 3 Marco RA, Gentry JB, Rhines LD. et al. Ewing's sarcoma of the mobile spine. Spine 2005; 30 (07) 769-773
• 4 Feng H, Wang J, Guo P, Xu J, Feng J. Revision surgical treatment of a second lumbar Ewing Sarcoma: a report of a rare case. Medicine (Baltimore) 2015; 94 (30) e1190
• 5 Sciubba DM, Hsieh P, McLoughlin GS, Jallo GI. Pediatric tumors involving the spinal column. Neurosurg Clin N Am 2008; 19 (01) 81-92
• 6 Fenoy AJ, Greenlee JD, Menezes AH. et al. Primary bone tumors of the spine in children. J Neurosurg 2006; 105 (04) , Suppl): 252-260
• 7 Akeda K, Kasai Y, Kawakita E, Seto M, Kono T, Uchida A. Primary Ewing sarcoma of the spine mimicking a psoas abscess secondary to spinal infection. Spine 2009; 34 (09) E337-E341
• 8 Kim HJ, McLawhorn AS, Goldstein MJ, Boland PJ. Malignant osseous tumors of the pediatric spine. J Am Acad Orthop Surg 2012; 20 (10) 646-656
• 9 Rao G, Suki D, Chakrabarti I. et al. Surgical management of primary and metastatic sarcoma of the mobile spine. J Neurosurg Spine 2008; 9 (02) 120-128
• 10 Sciubba DM, Okuno SH, Dekutoski MB, Gokaslan ZL. Ewing and osteogenic sarcoma: evidence for multidisciplinary management. Spine 2009; 34 (22) , Suppl): S58-S68
• 11 Liljenqvist U, Lerner T, Halm H, Buerger H, Gosheger G, Winkelmann W. En bloc spondylectomy in malignant tumors of the spine. Eur Spine J 2008; 17 (04) 600-609
• 12 Tomita K, Kawahara N, Baba H, Tsuchiya H, Fujita T, Toribatake Y. Total en bloc spondylectomy. A new surgical technique for primary malignant vertebral tumors. Spine 1997; 22 (03) 324-333
• 13 Oda I, Cunningham BW, Abumi K, Kaneda K, McAfee PC. The stability of reconstruction methods after thoracolumbar total spondylectomy. An in vitro investigation. Spine 1999; 24 (16) 1634-1638
• 14 Krepler P, Windhager R, Bretschneider W, Toma CD, Kotz R. Total vertebrectomy for primary malignant tumours of the spine. J Bone Joint Surg Br 2002; 84 (05) 712-715