Karthigeyan Madhivanan, Varma Goutham, Chatterjee Debajyoti, Tadakamalla Sai Shiva, Salunke Pravin, Goel Rajeev
Department of Neurosurgery, Postgraduate Institute of Medical Education & Research (PGIMER), Sector 12, Chandigarh, 160012, India.
Department of Histopathology, PGIMER, Chandigarh, India.
Childs Nerv Syst. 2024 Dec 16;41(1):52. doi: 10.1007/s00381-024-06719-8.
Primary spinal intradural malignant peripheral nerve sheath tumors (MPNSTs) are rare neoplasms, especially in children with a non-neurofibromatosis background. Scarce pediatric data exist with regard to such tumors. A 4-year-old child with a history of spastic limb weakness was operated for a foramen magnum spinal lesion (intradural and extradural) with imaging suggestive of schwannoma; the histopathology, however, was that of a MPNST. He underwent redo-surgery for recurrent infiltrating lesion, became ventilator dependent, and expired. Along with this case, we briefly discuss the relevant literature on pediatric primary spinal MPNSTs. The report represents an unusual site for spinal MPNST in a child with dual components. It is important for clinicians to consider such malignant lesions among the differentials of paediatric spinal intradural/ extradural lesions. Compared to that of adults and other regions, the prognosis for spinal intradural MPNSTs in children remains grim.
原发性脊髓硬膜内恶性外周神经鞘瘤(MPNSTs)是罕见肿瘤,尤其在无神经纤维瘤病背景的儿童中更为罕见。关于此类肿瘤的儿科数据稀缺。一名有痉挛性肢体无力病史的4岁儿童因枕骨大孔脊髓病变(硬膜内和硬膜外)接受手术,影像学检查提示为神经鞘瘤;然而,组织病理学结果却是MPNST。他因复发性浸润性病变接受了再次手术,术后依赖呼吸机,最终死亡。结合该病例,我们简要讨论了有关儿童原发性脊髓MPNSTs的相关文献。该报告显示了脊髓MPNST在一名具有双重成分的儿童中的不寻常部位。临床医生在鉴别小儿脊髓硬膜内/硬膜外病变时考虑此类恶性病变很重要。与成人及其他部位相比,儿童脊髓硬膜内MPNSTs的预后仍然严峻。