En bloc vertebrectomy of a thoracic Ewing sarcoma including posterior arch: 3 years later

Abstract

Ewing’s sarcoma of the mobile spine is a very rare pathology, especially after 30 years of age. The clinical manifestations and radiological aspects can be confusing, which delays the diagnosis. Approximately 25% of patients present with metastatic disease at diagnosis which worsen the prognosis. In localized forms the therapeutic goal is a surgical en bloc wide resection of the tumor, a restoration of spinal column stability and avoidance of recurrence through multimodal therapy including chemotherapy and radiotherapy. We report a case of primary Ewing´s sarcoma of 12th thoracic vertebra in 30 years old man treated with chemotherapy and a double approach en bloc vertebrectomy. The reconstruction was performed with anterior bone grafting and posterior stabilization. No tumor recurrence was observed at the 3 year follow-up assessment. Imaging and clinical aspects were analyzed as well as the management modalities and outcome. Keywords: Ewing sarcoma; thoracic spine; surgery; En bloc vertebrectomy.