Cervical Ewing's sarcoma presenting as neurinoma

Considering their usual bone localisation, Ewing's sarcomas of soft tissues are rare. We report a case of a 19-year-old patient who had been suffering from cervico-brachial neuralgia followed by symptoms of progressive spinal cord compression. Magnetic resonance imaging detected a tumour at the C [7] level in the antero-lateral part of the spinal canal with an intracanal extension via an enlarged inter vertebral foramen, mimicking a neurinoma. The patient underwent an incomplete tumoural exeresis. The pathological examination yielded typical findings of Ewing's sarcoma. The patient underwent chemotherapy followed by complementary tumoural exeresis and radiotherapy. Literature review denotes the exceptional feature of the presentation. Correct and definitive diagnosis is made by pathological examination. Management of Ewing's sarcoma with the three main modalities: surgery, radiotherapy and chemotherapy increase the patient's survival

Interacarnial hypertension revealing lumbar neurinoma

A 26-year-old woman was admitted with symptoms of raised intracranial pressure. On admission, neurological examination showed a bilateral papilloedema. There were no spinal, medullar or radicular sings and the brain computed tomography scan was normal. Lumbar puncture disclosed increased cerebrospinal fluid pressure [285 mm H2O]. CSF protein concentration was elevated [280 mg/dl] and glucose and cell counts were normal [respectively 56 mg/dl and 5 /mm3]. Magnetic resonance angiography eliminated a cerebral venous thrombosis. Considering the al-buminocytologic dissociation, a spinal magnetic resonance imaging [MRI] was done. It showed a cauda equina tumour. The patient underwent total resection of this intradural spinal tumour, via a posterior approach. The pathological diagnosis was neurinoma. A few weeks after surgery, symptoms of intracranial hypertension disappeared and eyes fundoscopy was normal. Similar cases in the literature were reviewed. Pathogeneses and mechanisms are discussed. We must keep in mind that some spinal tumours can appear under the mask of intracranial hypertension. Spinal MRI should be rapidly done avoiding delayed diagnosis and the risk of visual after-effects