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Paravertebral primitive neuroectodermal tumour presenting with Horner’s syndrome
  1. D N Parmar,
  2. N Lim,
  3. N Joshi
  1. Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK
  1. Correspondence to: D N Parmar, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK Accepted for publication 22 July 2002

https://doi.org/10.1136/bjo.87.3.366-a

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    We describe a peripheral primitive neuroectodermal tumour (PPNET) arising from the cervical paravertebral region of a 34 year old woman, who presented with Horner’s syndrome and a cervical radiculopathy. PPNETs are rare malignant small round cell tumours. This appears to be the first documented case of localised PPNET with Horner’s syndrome at initial presentation.

    Case report

    A 34 year old woman presented with acute left scapula pain, numbness of her left forearm, a left upper lid ptosis, and left hemifacial anhydrosis. Her symptoms disappeared spontaneously within a fortnight, but returned 2 months later with greater intensity. Examination then revealed wasting of the small muscles of her left hand with reduced power in the distribution of C8 and T1; there was loss of light touch and pinprick in the C8 dermatome. The presence of left 1 mm upper lid ptosis, miosis, hemifacial anhydrosis, and 1 mm lower lid (“upside down”) ptosis was highly suggestive of a preganglionic left Horner’s syndrome (Fig 1A). Magnetic resonance imaging …

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