{"id":"c2626fd0-cc4a-45ff-bfe7-f24fe68f6460","slug":"primary-atypical-teratoidrhabdoid-tumor-of-the-spine-in-an-adult-patient","title":"Primary atypical teratoid/rhabdoid tumor of the spine in an adult patient","authors":["Luyuan Li","Mohit Patel","Ha Son Nguyen","Ninh Doan","Abhishiek Sharma","Dennis Maiman"],"abstract":"Background: Atypical teratoid/rhabdoid tumor (AT/RT) is an aggressive neoplasm of the central nervous system that generally arises intracranially in patients under 2 years of age. Primary spinal AT/RT in an adult is rare. Case Description: A 23-year-old female presented with left lower extremity sciatica attributed to a magnetic resonance imaging (MRI)-documented intradural mass between L2 and L4. The lesion was biopsied (was unresectable) and treated with high-dose chemotherapy (methotrexate, vincristine, cyclophosphamide, etoposide, and cisplatin) with autologous hematopoietic stem cells rescue, followed by 2 months of radiation therapy (36 Gy to craniospinal axis, 20 Gy to lumbar region) with concurrent temozolomide; the latter was discontinued after 3 weeks due to myelosuppression. Tumor relapsed 1 year later at C7–T1 level. She was started on oral metronomic therapy, and bevacizumab was added 2 months later. Three months later, a cervical MRI showed progression of the tumor, along with new lesions in the thoracic/lumbar spine plus intracranial punctate nodular tumors. Following resection of the C7/T1 lesion, she was started on palliative alisertib; a month later, a cranial computed tomography showed progression of her disease with hydrocephalus. Treatment was discontinued, and she expired 12 months after initial diagnosis. Conclusion: Primary spinal AT/RT in the adult patient is rare. The pathology is associated with early recurrence and a poor prognosis. Although potential benefits of metronomic chemotherapy and alisertib have been reported, the patient in this study did not favorably respond to these modalities.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/c2626fd0-cc4a-45ff-bfe7-f24fe68f6460/featured/hero-1782420937209.png","publishDate":"2016-03-10T00:00:00.000Z","doi":"10.4103/2152-7806.178523","categories":["Case Report"],"fullTextUrl":"http://surgicalneurologyint.com/wp-content/uploads/2016/03/6643/SNI-7-27.pdf"}