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Intraoperative Ultrasound in Spinal Surgery
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Primary spinal epidural rhabdomyosarcoma: A case report.
Fahad Mahmood Okal1, Abdulaziz Hamzah2, Adnan Boubaker3
1Department of Surgery, Neurosurgery Section, King Abdulaziz Medical City, Ministry of National Guard, Jeddah, Saudi Arabia.
Surgical Neurology International
|April 7, 2023
Summary
Spinal rhabdomyosarcoma (RMS) is a rare, aggressive childhood cancer. This case highlights the challenges in diagnosing and treating spinal RMS, even with surgical intervention, due to its poor prognosis.
Area of Science:
- Pediatric Oncology
- Neurosurgery
- Musculoskeletal Tumors
Background:
- Rhabdomyosarcoma (RMS) is a malignant tumor of childhood, typically affecting skeletal muscles.
- While common in the head, neck, genitourinary tract, and limbs, spinal involvement is rare.
Observation:
- A 19-year-old male presented with cauda equina syndrome, indicative of spinal cord compression.
- Imaging revealed a C7/T1 lesion causing a pathological fracture, with additional lesions noted at T3 and S1-S2.
- Diagnosis of highly malignant alveolar RMS was confirmed via CT-guided biopsy and immunohistochemistry.
Findings:
- The patient underwent multi-level laminectomies and partial tumor debulking.
- Postoperatively, the patient experienced paraplegia, highlighting the severe neurological impact of spinal RMS.
- Histopathological confirmation identified the tumor as alveolar rhabdomyosarcoma.
Implications:
- Surgical resection is recommended for spinal RMS when feasible.
- The long-term prognosis for spinal RMS remains guarded due to high rates of recurrence and metastasis.
- This case underscores the aggressive nature of spinal rhabdomyosarcoma and the challenges in achieving favorable outcomes.
