PRIMARY SPINAL COLUMN SARCOMAS

Five cases of primary spinal column sarcomas are presented. Sarcomas p rimarily originating from paravertebral soft tissues were excluded. Pa tients' age ranged from 1 to 14 years (mean 8.4 years). The male : fem ale ratio was 2 : 3. Two patients had Ewing's sarcoma (ES) originating from L5-S1 and L4-5 pedicles, respectively; two patients had mesenchy mal chondrosarcoma (MCS) originating from L1-2 pedicles and L5 body, r espectively; and one patient had osteogenic sarcoma (OS) of C4 body. A ll patients clinically presented with pain and progressive weakness of the extremities. The time that elapsed between the onset of symptoms and diagnoses ranged from one to five months. All cases were treated w ith chemotherapy, radiotherapy and subtotal tumour resection with spin al canal decompression. Two cases received posterior spinal fusion ope rations. Three patients were alive 10 to 98 months following diagnosis . Only the case with ES of L5-S1 pedicles was in complete remission an d off therapy at the 98th postoperative month. The two MCS cases were in partial remission, and were receiving chemoterapy at the time of an alysis. These rumours caused similar clinical findings and prognoses, and required combined treatment, which consisted of surgery, radiother apy and chemotherapy; histologically three different types of malignan t rumours are presented in the same category. We preferred surgical de compression and stabilization procedures especially for neurologically symptomatic patients, even if they had extensive tumours with high gr ades. By spinal canal decompression and stabilisation, we did not inte nd to cure the disease; however, we intended to pro vide neurological improvement, spinal stabilisation, improved quality of life, early mob ilisation of the patient, and cytoreduction by means of surgical tumou r ablation, which could render the chemotherapy more effective.