Abstract
Although the spine is frequently involved in metastatic Ewing's sarcoma, primary involvement of the spine, beside sacrum, is much less frequent, especially in adult patients. Because of the low incidence of these tumors, there are currently no clinical guidelines outlining their management and a multitude of therapeutic strategies have been employed with varying success. The definitive management of Ewing's sarcoma of the spine, as in other locations, could include the combination of three main modalities: aggressive surgery, radiotherapy, and combined chemotherapy. Whenever possible, en bloc spondylectomy or extralesional resection is preferable, providing a better oncological result with a longer survival and a better preservation of the spine biomechanics. This is the lesson we learned about the case, we present here, of nonmetastatic lumbar localization by Ewing's sarcoma in as adult patient.
Highlights
Since its first description by James Ewing in 1921, Ewing’s sarcoma represented a strange kind of malignancy
Because of the low incidence of these tumors, there are currently no clinical guidelines outlining their management and a multitude of therapeutic strategies have been employed with varying success
En bloc spondylectomy or extralesional resection is preferable, providing a better oncological result with a longer survival and a better preservation of the spine biomechanics. This is the lesson we learned about the case, we present here, of nonmetastatic lumbar localization by Ewing’s sarcoma in as adult patient
Summary
Since its first description by James Ewing in 1921, Ewing’s sarcoma represented a strange kind of malignancy. Differentiated tumor of uncertain histogenesis with a variable biologic behavior, it presents heterogeneity inside. It is common in Caucasians and rarely arises in individuals of African and Asian ancestry. EWS is one of the most aggressive bone tumors with high proliferative and invasive potential, presenting a confusing variety of imaging manifestations that can mimic other diseases, especially in adult patients who already suffer of other spine pathologies [9,10,11,12,13]. In contrast to long bone involvement, delays in spinal EWS diagnosis may occur because symptoms may not be present until neurological deficits occur. Definitive diagnosis requires cytological and immunohistochemical analysis of a pathologic specimen
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