Ewing's sarcoma of the ilium mimicking inflammatory arthritis of the hip: a case report

Manzoor Ahmed Halwai,Anwar Hussain,Arshad Bashir,Mubashir Maqbool Wani,Bashir Ahmed Mir

doi:10.4076/1757-1626-2-6487

Abstract

IntroductionEwing’s sarcoma is second most common primary malignant bone neoplasm in children and adolescents. We report a case of Ewing’s sarcoma of ilium in an 18-year-old female mimicking clinically and radiologically inflammatory arthritis of hip joint, a rare entity not mentioned in literature.Case presentationAn 18-year-old girl presented with pain hip, limp and fever off and on. Patient had restricted range of motion, raised erythrocyte sedimentation rate, leucocytosis and radiograph showed reduced joint space. Magnetic resonance imaging pelvis revealed an altered marrow signal of acetabulum with a large soft tissue component. Histopathology revealed a malignant round cell tumor consistent with Ewing’s sarcoma.ConclusionClassical clinical and radiological presentation of Ewing’s sarcoma of ilium may not be the rule. One should be highly suspicious of the disease even if there is no direct pointer to the disease as was encountered in our case.

Highlights

Ewing’s sarcoma is second most common primary malignant bone neoplasm in children and adolescents
We report a case of Ewing’s sarcoma of ilium in an 18-year-old female mimicking clinically and radiologically inflammatory arthritis of hip joint, a rare entity not mentioned in literature
One should be highly suspicious of the disease even if there is no direct pointer to the disease as was encountered in our case

Summary

Introduction

Ewing’s sarcoma is a highly malignant tumor of bone and soft tissue in children and adolescents. ES is the second most common primary malignant tumor of bone in children with a characteristic predilection for an age group between 10-20 years [2]. These may lead to confusion with osteomyelitis and lymphoma. Case presentation We report a case of 18-year-old female patient, Asian Indian in origin presenting with one-month history of pain right hip, limp and fever off and on. Plain radiograph pelvis in AP view showed reduced right hip joint space with subtle, hard to pick changes in the right ilium (Figure 1). Patient has been on primary chemotherapy for 5 months and it will be continued for a month more

Discussion

Findings

Conclusion

Grier HE: The Ewing family of tumors