• Hiroshi Matsubara, Ken-ichiro Watanabe, Hidemasa Sakai, Hsi Chang, Hisanori Fujino, Yuri Higashi, Michihiro Kobayashi, Souichi Adachi, Shiro Seto, and Tatsutoshi Nakahata.
• Department of Pediatrics, Graduate School of Medicine, Kyoto University, Kyoto, Japan. hrmatsub@kuhp.kyoto-u.ac.jp
• Spine. 2004 Jan 1; 29 (1): E4-6.

Study DesignCase report.ObjectiveThe authors present a case of atypical Burkitt's lymphoma with multiple epidural involvements.Summary Of Background DataSpinal cord compression in children is an emergency that requires urgent attention to minimize neurologic dysfunction. Although it is not life-threatening in most patients, cord compression can cause severe neurologic morbidity.Materials And MethodsBecause the patient showed rapid neurologic deterioration, we started chemotherapy and high-dose steroids without laminectomy or radiotherapy immediately after a tumor biopsy from the left mandible.ResultThe combined therapies were very effective and his neurologic symptoms improved immediately. The epidural involved masses disappeared in imaging studies after the first course of chemotherapy including methylprednisolone (20 mg/kg per day for 3 consecutive days and gradually tapered off over 2 weeks), vincristine (1.5 mg/m2 per day), cyclophosphamide (2 g/m2 per day for 2 days) and pirarubicin (40 mg/m2 per day). After completing seven courses of chemotherapy, the patient is now fully ambulant.ConclusionConsidering the severe late effects of laminectomy and radiotherapy, chemotherapy should be considered as a first choice of treatment for spinal cord compression caused by malignant lymphoma.

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