Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: Tumours
Abstract number: 23855
EVERYTHING IS NOT TUBERCULOSIS
Mrinal SHARMA
University College of medical sciences, delhi (INDIA)
Primary malignant sarcomas of spine are rare constituting 3.5-14.9% of all primary
bone sarcomas and 3.2% cervical of all spine. An 11 yr girl presented with pain in
cervical spine and torticollis on the right side for 3 months. Tenderness and restricted
movements without neurological deficit. Radiographs revealed lytic lesion C2 with
increased soft tissue shadow and MRI a lesion in C2 with paravertebral soft tissue
collection with compression on cord.Diagnosed as Potts spine C2. The patient given
ATT,planned for CT guided biopsy and kept on crutchfield tong. discharged on
cervical orthosis after 6 weeks. The patient presented after 3 weeks complaining of
severe pain in the neck and weakness in all 4 limbs and incontinence of urine. The
patient had upper motor signs on presentation. Radiographs revealed destruction of
C2 vertebral body and MRI and CT demonstrated gross destruction of C2,
compression of cord. Taken for decompression, biopsy and fixation posteriorly,
revealed greyish white cheesy material with complete destruction of C2.As lesion
was vascular,debulking to relieve cord compression and occipito-cervical fusion was
done. The tissue subjected to histopathology which turned out to be undifferentiated
Ewings Sarcoma. The patient was given chemotherapy which she responded to but
later developed wound dehicence.she expired.Though tuberculosis is endemic
here,suspicion must be kept for malignancies that mimic Potts spine. Tissue
diagnosis is the key form the basis of treatment.
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