A Case Report of Small Round Cell Tumour in Paraspinal Region in HIV

INTRODUCTION: Small round cell tumours are a group of cytomorphologically similar neoplasms with varied origin. The neoplastic elements include undifferentiated, uniform, small round to oval closely packed cells with a solitary hyperchromatic nucleus and a high nuclear cytoplasmic ratio. They tend to involve skeletal system or soft tissue. This is a case of small round cell tumour in a HIV patient who is on Antiretroviral therapy. CASE HISTORY AND EXAMINATION A 44-year-old female who is a known case of HIV since 1year on Antiretroviral therapy presented with radicular pain, sensory disturbance, asymmetrical paraparesis with sparing of bowel and bladder. On examination Pulse 88/min regular, BP 120/80mmHg. Detailed CNS examination revealed a clinical picture of Cauda Equina syndrome lesion at L4 vertebral level. Blood investigations, X-ray LS Spine and X-ray chest, Nerve conduction study, MRI LS Spine, FNAC Paraspinal lesion were done. MANAGEMENT: Patient was treated symptomatically with pregabalin, nortriptyline, methylcobalamine, physiotherapy. She was referred to higher centre for immunohistochemistry and radiotherapy. DISCUSSION: Small round cell tumors are malignant neoplasms of heterogenous variety which differ from each other with respect to site of occurrence and variety. It commonly occurs in young children and adolescent age group. They require immunohistochemistry molecular genetics and flow cytometry for differential diagnosis. There are very few cases have been reported to have an association with HIV.