UNUSUAL CASE OF PARAPLEGIA IN AN ADOLESCENT MALE WITH NORMAL

This is a case report describing an atypical presentation of Ewings sarcoma involving the lumbar spine in an adolescent male, presenting to a tertiary spinal cord rehabilitation centre. A 1year old male presented with acute low back pain and subsequent ascending lower limb paralysis associated with bowel and bladder dysfunction over a period of 2 weeks. Since initial plain radiographs showed no obvious abnormality, patient was evaluated for causes of myeloneuropathy until an MRI spine showed the full extent a lesion involving the L1 vertebra. Although it commonly affects the metaphyseal region of long growing bones, involvement of the non-sacral spine is rare in Ewings sarcoma. Usually a late complication in the clinical course of events, paraplegia may be a presenting feature among these tumors. Hence, atypical progression of paraplegia in the adolescent age group with no prior history of trauma, and normal plain radiographs should also be evaluated early for malignant disease.