P.143 Spinal cord intramedullary malignant peripheral nerve sheath tumour: case report and review of literature
Bibliographic record
Abstract
Background: Malignant peripheral nerve sheath tumours (MPNST) are uncommon but aggressive neoplasia associated with radiation exposure and neurofibromatosis (NF). These tumours are often found in the trunk, extremities, head and neck, with capacity to metastasize. Only a handful of case reports have described intramedullary spinal cord MPNST. Methods: We report the case of a 35 year-old female who presented with progressive gait disturbance and paraparesis. MRI of the spine demonstrated an enhancing intramedullary mass at the C7 vertebra. Laminectomy with expansile duraplasty, and extended surgical biopsy were performed for cord decompression and tissue diagnosis. Results: Pathological sections demonstrated a spindle cell neoplasm with nuclear atypia, frequent mitotic figures, focal necrosis, and infiltration into adjacent neurological tissue. It was positive for S100, SOX10, p53 with partial loss of INI-1. Diagnosis of spinal intramedullary MPNST was confirmed, however given the prior history of remote trigeminal MPNST, it was unclear whether the mass represented a delayed metastasis, or a de novo neoplasm. Conclusions: Typically relegated to the periphery, our case represents a rare spinal medullary presentation of MPNST. While the differential for tumours in this location typically includes diffuse astrocytomas, ependymomas, and rarely schwannomas, we move that consideration of MPNST in select high risk cases advise surgical planning and subsequent therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.003 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.007 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".