Intralesional surgery of primary tumors of the anterior cervical column.

The study involves a series of 10 primary neoplasms of the anterior cervical column (body and transverse processes) surgically treated by intralesional excision and followed-up after 2-10 years. The series included 6 benign and 4 malignant neoplasms. Among the benign tumors 4 cases were classified Enneking stage II (2 osteoid osteomas, 1 fibrous dysplasia, 1 osteoma): after simple excision none of the cases revealed symptoms or signs of recurrence at long-term follow-up. The other 2 benign forms were stage III (giant cell tumor and aneurysmal cyst): both of the cases were treated by extracapsular intralesional excision after selective arterial embolization and reconstruction with anterior fusion; the giant cell tumor was irradiated after surgery: at long-term follow-up the patients were asymptomatic and there were no signs of recurrence. The 4 malignant neoplasms (stage IIB) were 1 osteosarcoma and 3 solitary plasmacytomas with spinal cord compression. The osteosarcoma was treated by intralesional excision in 3 stages and radiation therapy, and there were no signs of disease 6 years after diagnosis. The cases of plasmocytoma were treated by intralesional excision and spinal cord decompression, anterior fusion with iliac graft and plate, radiation therapy, and chemotherapy, and they died after 2, 3 and 4 years with findings of multiple myeloma with no signs of disease at the level of the cervical vertebra treated.