✓ Paget disease is an idiopathic metabolic disease of bone that may involve the axial and appendicular skeleton. In up to one third of patients there may be pagetoid involvement of the spine, which can cause back pain and vertebral collapse, with instability or myeloradiculopathy. Although medical therapy is the mainstay of treatment, decompressive surgery or stabilization may be required. The authors report on a case of localized Paget disease of the spine treated successfully by performing percutaneous vertebroplasty. They propose this procedure as a useful intervention that can be undertaken safely in patients with spinal Paget disease, in whom acquisition of a transpedicular biopsy sample is required as part of diagnosis.
M. Adam Kremer, Al Fruin, Theodore C. Larson III, John Roll and Robert J. Weil
Robert J. Weil, Zhengping Zhuang, Svetlana Pack, Shimareet Kumar, Lee Helman, Brian G. Fuller, Crystall L. Mackall and Edward H. Oldfield
✓ Molecular biological techniques have begun to transform modern medicine. These techniques have shown promise in the pathological diagnosis of difficult or uncommon tumors. Accurate molecular diagnosis of the small round-cell tumors, for example, is especially important because divergent therapies may be required to eradicate such disparate lesions as neuroblastoma, lymphoma, rhabdomyosarcoma, central primitive neuroectodermal tumors/medulloblastoma, or Ewing sarcoma (ES). The authors present an unusual case of a primary, extraosseous ES arising from the intramedullary spinal cord, in which molecular studies were required for specific diagnosis and therapeutic guidance.