The patient came to the clinic 14-September-2014 complaining of neck and right upper limb pain for 2 months with numbness all fingers right hand for 2 weeks. The patient was operated 3 years for lymphnode biopsy, which was proved to be Hodgkin disease for what radiation and chemotherapy was performed. She was treated for left kidney abscess 3 months ago with antibiotics (Meropnem).

On examination; the patient in agonizing pain and cannot rotate the neck to all sides with severe pain. There is weak grip right hand -3/5 and unable to extend the hand and weak right triceps 1/5 and weak biceps 4/5. There is hypalgesia of the Index finger right hand.

The patient was sent for MRI of the cervical spine with contrast showing tumor of C7 with complete destruction of the body with right paraspinal growth toward the brachial plexus. Bone scan done 15-September-2014 ruling out scattered MTS picture.

There is no running crease in the neck to reach the lesion and there is solid palpable mass 1 cm above the sternoclavicular notch. For that an incision was carried out along the medial border of the right sternocliedomastoid muscle. Dissection was started from above and the C6-7 and C7-D1 levels were identified. A mass was identified in the right side of C7 pushing the muscles antero-lateral, but not reaching the sheath of the right CCA. The mass which was felt before incision was a bony one in the right lobe of thyroid not having any relation to the pathological lesion. Discectomy C6-7 and C7-D1. The disc material was not involved in the tumor. The C7 body was destroyed by the tumor and it was resected. The soft tissue component of the tumor in the right side of the body was also removed  obtaining practical radical resection of the tumor. Fresh frozen section gave the answer of Hodgkin sarcoma of very malignant behavior. Using Medulex expandable cage 16 mm 4⁰ with allograft 15 cc was inserted at the bone defect between C6 and D1. Using Reflex plate 2 level 30 mm plate and 4 fixed self drilling screws, fusion of C6 and D1 was achieved. Routine closure of the wound. The histological specimens were sent to separate pathological departments.

Smooth postoperative recovery. The power of the right upper limb became normal and the agonizing pain disappeared.

If the patient has Hodgkin sarcoma, then it is very rare and it is not invading the disc material.