Primary Ewings Sarcoma Of The Lumbar Spine Presenting As Cauda Equina Syndrome

A 16 year old girl presented with low back ache and insidious progressive weakness of both lower limbs of 2 months duration with bilateral foot drop. She had bowel and bladder incontinence . MRI of Lumbo sacral spine showed lytic destruction with irregular soft tissue mass involving the spinous process L3 in to spinal canal and erector spinae muscles causing significant narrowing and extradural compression on the cauda equine ( L3 4) roots. A CT guided FNAC was suggestive of PNET. She underwent L3,4 decompressive laminectomy with biopsy of tumor tissue. Immunohistochemistry showed CD 99 positivity suggestive of Ewings sarcoma. Postoperatively lower limb power improved. The patient has received chemotherapy but incontinence persisted.