Abstract

This report details the CT and MR imaging findings of a primary orbital Ewing’s sarcoma case involving the middle cranial fossa in a 13-year old boy. CT showed an ill-circumscribed homogeneous soft-tissue density mass with needle-like bone reaction. On MRI, the mass showed homogeneous iso-intensity on T1WI, heterogeneous hyper-intensity on T2WI, and marked homogeneous enhancement. Meanwhile, the mass was hyper-intense on DWI, and ADC value was 575×10-6 mm2/s. The mass showed as high rCBV and rCBF, prolonged MTT based on DCS-PWI, and wash-out pattern of TIC derived from the DCE-MRI. Our case suggests that functional MRI modalities, including DWI, DSC-PWI or DCE-MR, could provide additional information for differential diagnoses. Both CT and MRI should be performed and comprehensively analyzed for limiting differential diagnoses, determining lesion extension and facilitating operative approach.

Highlights

  • Ewing's sarcoma (ES) is a malignant neoplasm that mostly arises in the skeleton and was first described by James Ewing in 1921[1]

  • The mass showed as hyper-intensity on diffusion weighted imag­ ing (DWI), low apparent diffu­ sion coefficient (ADC) value on ADC map (Fig. 1D), and ADC value of the mass was 575×10 mm/s

  • Previous studies indicate that ESs occur in a peak age range of 5-13 years and 90% of cases occur by the age of 30 years[1]

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Summary

Introduction

Ewing's sarcoma (ES) is a malignant neoplasm that mostly arises in the skeleton and was first described by James Ewing in 1921[1]. Skeletal Ewing's sarcoma typically involves the long bones and rarely occurs in the orbit. Fewer than 20 cases of orbital ES have been reported in the English literature and most reports focused on pathological or clinical finding[1,2,3]. The CT or MR imaging (MRI) findings of orbital ESs have not been reported. We report the CT and MRI findings of a primary orbit ES involving the middle cranial fossa in a 13-year old boy. This case report was approved by the Institutional Review Board in our hospital according to the CARE guidelines

Case report
Findings
Discussion

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