• Mohamad Bydon, Rafael De la Garza-Ramos, Ian Suk, Edward McCarthy, Yoshiya Yamada, Jean-Paul Wolinsky, and Ziya L Gokaslan.
• Departments of ‡Neurosurgery and §Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland; ¶Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York.
• Neurosurgery. 2015 Aug 13.

Background And ImportanceOccurrence of spinal epithelioid sarcomas is rare, with few cases reported in the literature. Although wide local resection is the recommended treatment, this technique is challenging in the spine.Clinical PresentationThe case of a 17-year-old male with a recurrent epithelioid sarcoma with intradural extension in the cervical spine is presented. Because of nerve root involvement, the patient presented with right upper extremity weakness. The patient underwent a posterior C1-C4 spondylectomy to achieve an en bloc resection, followed by reconstruction from the occiput to T4. The right vertebral artery and C1-C4 nerve roots were sacrificed because of tumor involvement. After 3 years of follow-up the patient is disease-free but has persistent right deltoid weakness.ConclusionCervical spondylectomy via a single-staged posterior approach is a challenging yet feasible procedure for the treatment of epithelioid sarcomas. To the best of the authors' knowledge, this is the first report of complete resection of an epithelioid sarcoma with intradural extension in the cervical spine. Although neurovascular structures may warrant sacrifice, this procedure may provide improved long-term prognosis.AbbreviationsES, epithelioid sarcomasMEP, motor evoked potentialSSEP, somatosensory evoked potential.

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