Fig. 9.

An 18-year-old girl had a 1-month history of back pain without any obvious cause and experienced muscle weakness in both legs The patient suffered numbness and urinary disturbances. a Plain X-ray showing the loss of spinous processes at the T5 level (arrow). b CT detected a spotted osteolytic lesion in the lamina of the T5 vertebra. c T2-weighted MRI showed a mass that exhibited iso-signal intensity and was compressing the spinal cord from the posterior direction (arrow). d Emergent decompression of the T4-6 vertebrae was performed to rescue the spinal cord from compression. Preoperative chemotherapy composed of VDC + IE was performed, 45 Gy radiation was administered as a local treatment, and VDC-IE was administered as a post-local therapy. The patient became completely free from spinal palsy and was able to walk without any support. She has been disease-free for 6 years after the local treatment