Multiple Spinal Intramedullary Primitive Neuroectodermal Tumors Mimicking Acute Myelitis

Area of Science:

• Neuro-oncology
• Spinal cord neoplasms

Background:

• Primitive neuroectodermal tumors (PNETs) are rare, malignant spinal cord neoplasms.
• PNETs originate from undifferentiated or poorly differentiated neural crest cells.
• Imaging findings for PNETs often lack specificity, complicating diagnosis.

Observation:

• A 16-year-old male presented with progressive lower extremity weakness and numbness.
• MRI revealed multiple intramedullary lesions mimicking acute myelitis.
• Initial diagnosis of tuberculosis and tuberculous meningitis was made but later disproven.

Findings:

• Histopathology confirmed the lesions as Primitive neuroectodermal tumors (PNETs).
• The case demonstrated PNETs presenting with multiple spinal cord lesions.

Implications:

• Multiple spinal PNETs can initially mimic acute myelitis on MRI.
• PNETs should be considered in the differential diagnosis of spinal cord lesions with myelitis-like presentations.