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 CASE REPORT
Year : 2007  |  Volume : 55  |  Issue : 1  |  Page : 64--66

Intraosseous malignant peripheral nerve sheath tumor with focal epithelioid differentiation of the thoracic spine


1 Department of Orthopedic Surgery, Akita University School of Medicine, Akita 010-8543, Japan
2 Department of Pathology and Immunology, Akita University School of Medicine, Akita 010-8543, Japan

Correspondence Address:
Naohisa Miyakoshi
Department of Orthopedic Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.30431

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The authors describe an extremely rare case with malignant peripheral nerve sheath tumor (MPNST) with focal epithelioid differentiation presenting as an intraosseous lesion of the spine. A 75-year-old woman presented with progressive paraplegia caused by epidural mass arising from the posterior element of the T7 vertebra. At surgery, the lesion was noted to originate from the T7 vertebra and separate from the dura and spinal nerve roots. The patient died of tumor metastases to the lungs six months after the initial presentation. Histological diagnosis was MPNST. However, the tumor also contained cystic structures lined by epithelioid cells, requiring differentiation from synovial sarcoma. From the histological and immunohistochemical features, as well as the absence of SYT-SSX fusion gene expression, the diagnosis of MPNST with focal epithelioid differentiation was made. This is the first case report of intraosseous MPNST of the spine with a peculiar biphasic appearance.






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Online since 20th March '04
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