Management of pathological femoral fracture secondary to Ewing sarcoma in pregnancy: A case report

Abstract

Ewing's sarcoma is an ultra-orphan disease (2/1,000,000/year) which requires a multimodal therapy approach in high-volume centers. Treatment consists of pre-operative therapy followed by surgery and post-operative combination of chemo-radiotherapy. Experience with diagnosis and therapy of Ewing's sarcoma in pregnancy is very limited. We herein report the case of an atypical Ewing's sarcoma detected in the second trimester of gestation. The present study reports a case of a 24-week primigravida presenting with presented with chief complains of sudden onset of pain in left proximal thigh and inability to stand from bed on 28 feb.2017 in early mornig. Consult local doctor where x ray advice & some analgesic given. X-ray done at periphery which shows pathological subtrochantric fracture. From there she refer to higher centre for further management. An internal fixator was placed in the left femur for definitive treatment of the fracture. Normal delivery was performed at 32 gestational weeks. Following delivery, staging of cancer was conducted. Subsequently, adjuvant treatment started. The rare nature of this condition underlines once more the need for a multidisciplinary team to improve the quality of care for this highly special patient collective.