Case report of cervical intraspinal primitive neuroectodermal tumor and literature review / 中国综合临床

Objective To investigate the clinical characters and therapy of primitive neuroectodermal tumor(PNET).Methods A retrospective analysis was conducted.A 36-year-old female patient was showed pain and numbness of the right upper limb and back for 6 months.The cervical spine MRI showed a spindleshaped intradural mass right ventrolateral of spinal cord at C5-7 with in homogeneously enhancing.Surgery and pathologic examination confirmed that was PNET.Combiled with a series of literatures to analyse the clinical characters Results Surgery was performed to remove the tumor and decompression combined with radiotherapy.The pathologic examination and immunohistochemical analysis revealed that it was PNET.MRI identified local recurrence in spinal canal at 3 month later after surgery.Conclusion Spinal PNET is an uncommon intraspinal tumor with poor prognosis.Histopathology is the evidence of diagnosis.Optimal therapy has not yet been found.Surgical resection with the combination of chemo-radiotherapy or radiotherapy might get the better outcomes.Multidisciplinary treatment should be further clinical required.

The hangman’s fracture.

Eleven patients with hangman’s fracture admitted into Siriraj Hospital Between 1978 and 1984 were studied and analysed. Automobile accident (73%) and falling (18%) were the most common causes of this injury. The mechanism of the injury was acute hyperextension of the head on the upper cervical spinal. Because the fracture occurring at the greatest anteroposterior diameter of the cervical spine canal, the spinal cord injury was rarely associated with this lesion. Radiographic findings of the hangman’s fracture were bilateral fracture of the pedicles of the axis with or without anterior dislocation of C2 on C3. The degree of displacement varied from minimal to severe. However the posterior fragment usually retained its normal relationship to the posterior arch of C3. Retropharyngeal soft tissue swelling served as a general clue to the presence of this injury and an avulsion fracture or compression of the anterosuperior margin of the body of C3 was an additional finding of the lesion. Differential diagnosis of the hangman’s fracture should be made from the congenital spondylolisthesis of the axis.