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[Clinical Picture] A cervical spine mass caused by

In June, 2014, a 5-year-old girl from New Mexico with trisomy 21 presented with 2 months of neck pain, without neurological findings on examination or cutaneous abnormality. MRI showed an avidly enhancing, dural-based mass from C2 to C4 causing spinal cord compression (figure). Imaging of the neuraxis was otherwise negative. The radiographic findings suggested a peripheral nerve sheath tumour or meningioma, despite the rarity of such tumours in children. At operation we resected a firm rubbery mass arising from the dura (figure) via an intradural approach.