Malignant Tumors in the Cervical Spine in Adolescence -Report of Three Cases-

We report three cases of young patients with malignant tumors in the cervical spine who underwent decompression surgery.Case 1. A 16-year-old male was admitted to our hospital with progressive tetra-paresis and neck pain. Plain radiographs at C5 showed sclerosis. He underwent subtotal resection of the C5 body with fusion and radiotherapy. The histological diagnosis was Ewing's sarcoma.Case 2. A 19-year-old female was admitted with bilateral numbness in her upper extremities after a traffic accident. CT findings showed destruction at the C6 body and lamina. She underwent subtotal resection of C6 with anterior and posterior spinal fusion, radiotherapy and chemotherapy. The tentative histological diagnosis at surgery was chordoma. However, the autopsy results showed metastatic thyroid cancer.Case 3. A 25-year-old male was admitted with severe neck pain and progressive tetraparesis. Plain radiographs and CT findings showed destruction at the C3 body. The spinal cord at C3/4 was compressed by an anterior mass, on MRI. The treatment was similar to that for Case 2. The histological diagnosis was malignant meningioma.Both Cases 2 and 3 who underwent anterior and posterior spinal fusion, had a postoperative recovery period of 3 to 4 months without ADL disturbance. However all three cases died of multiple lung metastases within 1 year and 7 months after surgery.