Progrediente lähmungen infolge eines strahleninduzierten zervikalen malignen peripheren nervenscheidentumors

History and diagnosis. A 59-year old engineer was admitted to the hospital because ofpain in his right collar region and the onset of incomplete paresis of the right arm. Magnetic resonance tomography displayed an advanced tumour arising from the right paravertebral soft tissue. Histological examination revealed a malignant peripheral nerve sheath tumor (MPNST). Thirteen years before admission, the patient had a right sided tumor-tonsillectomy squamous cell carcinoma and local radiation of a cystic squamous cell carcinoma in the ipsilateral cervical soft tissue. Clinical course and therapy. In the following course, progressive neurological symptoms occurred including beginning paraplegia, right phrenic paralysis and a severe concomitant pain syndrome. Due to the location and advanced tumor state, surgical treatment was not performed and palliative chemotherapy remained ineffective. Three months later the patient died due to rapidly progressive neurological failure. Conclusion. MPNST represents a rare entity which has been related to postoperative radiation. Unusual neurological symptoms in anatomical regions of former rädiatiòn-should therefore include neurogenic secondary malignacies in the differential diagnosis for early surgical intervention.