Abstract
Ewing’s sarcoma (ES) is a rare and highly aggressive tumor belonging to a family of neoplasms of neuroectodermal origin, which primarily affects the bones or soft tissues. ES originating from lung parenchyma without chest wall involvement is extremely rare with less than 40 cases reported in the English literature. A 41-year-old man admitted to the thoracic surgery department presenting with intermittent non-productive cough, dyspnea, left-sided chest pain for two months for further evaluation and treatment with a preliminary diagnosis of pulmonary mass. Contrast-enhanced thorax CT and MRI revealed a large heterogeneous soft-tissue mass in the left lower lobe with no distant metastases or occult primary tumor. Following the percutaneous transthoracic biopsy, histopathological and immunohistochemical results were consistent with primary pulmonary ES. Though rare, primary pulmonary ES should be considered in the differential diagnosis of young patients presenting with a large heterogeneous soft tissue mass in the lung. This case report highlights the diagnosis, radiologic and pathologic findings, and management of primary pulmonary ES.
Highlights
Ewing’s sarcoma (ES) originating from lung parenchyma without chest wall involvement is extremely rare with less than 40 cases reported in the English literature
Contrast-enhanced thorax computed tomography (CT) and magnetic resonance imaging (MRI) revealed a large heterogeneous soft-tissue mass in the left lower lobe with no distant metastases or occult primary tumor
Primary pulmonary ES should be considered in the differential diagnosis of young patients presenting with a large heterogeneous soft tissue mass in the lung
Summary
The Ewing’s sarcoma family tumor (ESFT) are rare malignant tumors originating from neuroectodermal cells that commonly affect the long bones, such as arms, legs, ribs, vertebral column, and pelvis. The purpose of this report is to present a case of primary extraosseous ES of the lung presenting with a rapidly growing large heterogeneous soft tissue mass in light of the literature. A chest radiograph confirmed a large pleural effusion and total atelectasis of the left lower lobe. Contrastenhanced CT and MRI revealed a large, relatively well-defined, noncalcified heterogenous soft tissue mass measuring approximately 15x15x14 cm within the left lower lobe that compressed and displaced the left hilum, mediastinum and left atrium and ventricule (Figure 1). The image shows a large, relatively well-defined, noncalcified heterogenous soft tissue mass (star) within the left lower lobe that compressed and displaced the mediastinum and left ventricule (arrow). The images demonstrate the large heterogenous soft tissue mass (star) within the left lower lobe that compressed and displaced the mediastinum and left ventricule (arrow).
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