Monitoring an Intraosseous Malignant Peripheral Nerve Sheath Tumor of the Thoracic Spine: A Case Report and Review of Literature
There have been only a few studies at present, including systematic examinations of malignant peripheral nerve sheath tumours (MPNSTs) with spinal involvement. According to a few studies and sparse review literature[1,2,3,4], MPNSTs with spinal involvement are still regarded as a rare topic. Although both MPNSTs of paraspinal soft tissue (type 1) resulting in secondary vertebral destruction and MPNSTs arising predominantly from intraosseous vertebrae themselves (type 2) have been identified, these types of tumours are extremely rare. In this present study, the case of type 2 MPNSTs not linked to neurofibromatosis type 1 (NF 1) occurring in the thoracic spine has been illustrated and the clinical, radiological and pathological aspects of our experience in the treatment of this unusual condition have been reviewed, as well as shared. The treatment of choice for the selected case of spinal MPNSTs may be complete en bloc spondylectomy from our study to date. A delicate preoperative surgical preparation and management in selected patients can safely execute a posterior-only approach. Interestingly, even in cases of successful en bloc resection with adjuvant treatment, MPNSTs typically have a high rate of recurrence, both local and metastasis, but not in our 5-year follow-up.
Dr. Chaisiri Chaichankul
Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
Department of Orthopaedics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea.
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