Primary malignant peripheral nerve sheath tumor at unusual location
A 60-year-old male presented with rapidly enlarging painless swelling in back with lower limb weakness in a period of 2 month. On examination, lower motor type of paralysis was found in both the legs with power: 0/5 around all joints. Sensation of all modalities decreased below L3. A nontender hard lobulated mass of size 10 × 5 cm was found over left lumbar paraspinal area fixed to underlying structure []. MRI was suggestive of lumbar (L1-L4) extradural lesion with associated L3 vertebral body compressional collapse giving a picture of neurofibroma []. Near total excision of both intraspinal and paraspinal component was achieved. Histopathological examination and immunohistochemical staining confirmed the diagnosis of MPNST. Patient improved neurologicaly with power 2/5 around all joints in lower limb. On completion of local radiotherapy at 6-month follow-up, the patient was doing well with no local or systemic spread.