Epidural spinal cord compression in children with solid tumors


Kebudi R. , Ayan I. , Tokuc G., Darendeliler E., Bilge N.

INTERNATIONAL JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY, vol.5, no.5, pp.373-377, 1998 (Journal Indexed in SCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 5 Issue: 5
  • Publication Date: 1998
  • Title of Journal : INTERNATIONAL JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY
  • Page Numbers: pp.373-377

Abstract

The incidence of epidural spinal cord compression in pediatric malignancies is reported to be about 3%. Early diagnosis is important, since delay in diagnosis may lead to significant morbidity. In this retrospective study, 15 children (8 boys and 7 girls) having epidural spinal cord compression among 551 pediatric patients with malignancies (2.7%) admitted to the Division of Pediatric Oncology, Oncology Institute, between September 1989 and December 1995 have been reviewed. The median age at diagnosis was 6 years (range, 1 month to 14 years). Spinal cord compression occurred in 7 patients with sarcomas, in 2 with non-Hodgkin's lymphomas, in 3 with neuroblastomas, in 2 with germ cell, tumors and in 1 with Wilms' tumor. Motor weakness occurred in 87%, sphincter dysfunction in 87%, back pain in 53%, sensory abnormalities in 33%, and extremity pain in 27% of the patients. The median time from onset of symptoms to diagnosis of spinal cord compression was 1 month (range, 3 days to 6 months). Urgent treatment consisted of surgical decompression and laminectomy in 3 patients, radiation therapy in 4, surgical decompression and radiotherapy in 6 and only chemotherapy in 2. Neurologic dysfunction recovered completely in 5 and partially in 6 patients at a median time of 2 months. Early recognition of symptoms and signs of cord compression and immediate therapy are necessary to avoid significant morbidity.