Transoral resection and reconstruction for primary osteogenic sarcoma of the second cervical vertebra

Study Design. A case of primary osteogenic sarcoma at the second cervical v ertebra is reported. Objectives. To document an osteogenic sarcoma of the second cervical verteb ra and its treatment, and to review the literature. Summary of Background Data. Primary osteosarcoma of the cervical spine is e ncountered infrequently, and its location in the upper cervical spine is ex tremely rare. Two cases of osteosarcoma in the second cervical vertebra hav e been reported previously in the literature. Methods. A 15-year-old boy with a mass lesion in the, axis was treated surg ically by anterior transoral resection,. fusion, and reconstruction of the defect with a Harms cage. The resection was completed by posterior excision of the remaining vertebral elements, and by occipitocervical instrumentati on and fusion between the occiput and the fourth cervical vertebra. The the rapy was completed by adjuvant chemotherapy and radiotherapy. Results. At this writing, 40 months after the initial diagnosis, the patien t was in a good state of health with his underlying disease. Conclusions. The axis is a very rare location for the occurrence of primary osteosarcoma. Osteosarcoma-may histologically mimic chondroblastoma. The a xis can be surgically exposed, resected, and instrumented transorally. The stabilization must be augmented by posterior occipitocervical fusion.