Diagnosis and treatment of spinal primitive neuroectodermal tumor

崔益亮(Cui Yiliang，Dept Or- thop，Peking Univ 3rd Hosp，Beijing 100191)…∥Chin J Orthop.－2011，31(1).－13～17

Diagnosis and treatment of spinal primitive neuroectodermal tumor

崔益亮(Cui Yiliang，Dept Or- thop，Peking Univ 3rd Hosp，Beijing 100191)…∥Chin J Orthop.－2011，31(1).－13～17

ObjectiveTo sum up the clinical experience in diagnosis and treatment of spinal primitive neuroectodermal tumor(PNET).MethodsThirteen patients with spinal PNET were included in the study from 1999 to 2009.There were 8 males and 5 females with the mean age of 26.9 years.The lesions involved the cervical spine in 6 cases，the thoracic segment in 1 case，the lumbar segment in 5 cases and the sacrum in 1 case.The diagnosis of PNETs was made in nine patients by postoperative pathological examination.Among them，6 patients received a preoperative CT-guided percutaneous biopsy.The other four patients were diagnosed only by CT-guided percutaneous biopsy.Osteolytic bony lesions and obvious neurological deficit were found in ten patients，while the other 3 complained of local pain only.Nine patients received operation followed by chemotherapy and radiotherapy.The other 4 underwent only chemotherapy and radiotherapy.The changes of symptoms and time of survival were recorded.ResultsEleven patients were followed up with the mean of 21.8 months.The back pain in 7 patients who underwent operation relieved one month after the operation.The bladder and bowel function returned to normal condition after the operation.Among them，four patients died postoperatively.The mean survival time was 11.3 months.The otherthree patients survived with an average of 36 months.Three patients who only received chemotherapy and radiotherapy died with an average of 7 months，while the other patient survived 5 months.ConclusionThe diagnoses of spine PNET mainly depend on pathological examination.Percutaneous CT-guided biopsy is a reliable method to confirm diagnosis of tumor before surgery.The mortality rate of spinal PNET which is a highly malignant tumor is high.Operation can relieve clinical symptoms and improve patients’life quality，but not prolong the survive time.14 refs，3 figs， 1 tab.

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