Abstract
Primary bone tumours account for 5% of all adolescent and child cancers. When Ewing’s sarcoma arises in soft tissue rather than bone, it is referred to as extraskeletal Ewing’s sarcoma (ESS). Computed tomography (CT) scanning and magnetic resonance imaging (MRI) features of Ewing’s sarcoma are non-specific, and a radiological differential diagnosis should be considered. Ewing’s sarcoma is confirmed by features on histological analysis. In young people who present with soft-tissue tumours, ESS should be considered. In the management of patients with tumours, imaging techniques are useful for biopsy guidance, evaluating the possibility of resection, and tumour response to treatment.
Highlights
Primary bone tumours account for 5% of all adolescent and child cancers
We describe the presentation and outcome of 2 cases of extraskeletal Ewing’s sarcoma (EES)
About 25% of sufferers will present with metastatic disease, the most common sites for metastases being the lung (50%), bone (25%) and bone marrow (20%)
Summary
The selected axial CT slice at level L3 noted sclerosis and smooth volumetric expansion of the right pedicle These bony changes were not in keeping with a primary bony neoplasm and thought to be reactive change secondary to the large associated soft-tissue tumour (Fig. 2). Special investigations included normal blood work and a normal CXR; a whole-body bone scintigraphy study demonstrated multiple osteoblastic metastases in the skull, ribs, both scapulae, the superior and inferior pubic rami on the left, both femurs and the proximal two-thirds of the right humerus (Fig. 4a). At a multidisciplinary team meeting, a clinico-pathological and radiological correlation of the MRI and CT confirmed the large paraspinal mass of the right L3 pedicle and transverse process with soft-tissue mass in the extradural space These findings were consistent with a malignant tumour and suggested PNET/Ewing’s sarcoma. He completed 12 cycles of chemotherapy and is currently in clinico-radiological remission and disease-free for 6 months
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