Case Of Extraosseous Ewing's Sarcoma Research Articles

Rare origin - Ewing's sarcoma of the pleura: a case report and literature review

Ewing sarcoma (ES) was first reported by Ewing in 1921. It is the second largest malignant bone tumor in children and adolescents, typically occurring in the bones of trunk or limbs . Extraskeletal Ewing sarcoma (EES) was first reported by Tefft et al. in 1969 and is extremely rare, accounting for less than 1% of all sarcomas. It can occur in any part of soft tissue, mostly in the trunk and lower limbs, and rarely in the pleura. We report a 22-year-old case of extraosseous Ewing sarcoma of pleural origin discovered and pathologically confirmed by physical examination. We report its CT manifestations and pathological results, and review the literature to summarize and analyze the clinical and imaging characteristics of extraosseous Ewing sarcoma, in order to improve our understanding of the disease.

Primary Ewing's sarcoma of the jejunum presenting as sepsis

Extraosseous Ewing's sarcoma (ES), also referred to as extraskeletal ES, is a rare tumor of primitive cells that occurs in children, adolescents, and young adults. This tumor mainly involves the soft tissue of the extremities and thorax. We report a case of extraskeletal ES of the jejunum without associated skeletal location. A 26-year-old woman with no medical history presented to the emergency department with a 3-day history of a fever along with nausea, vomiting, and abdominal pain. An abdominal contrast computed tomography scan revealed a homogeneous bowel mass size 8.5 cm × 4.3 cm × 6.1 cm in the lower abdomen with invasion of the ileum is noted. Extraluminal free air and abscess formation size 10.6 cm × 5.2 cm × 8.3 cm is noted, suggestive of bowel perforation. After the surgery, the specimen was sent to the pathology department for examination. We received one segmental jejunum (25 cm in length and 6 cm in diameter of the lumen) that weighed 450 g in total. Sections revealed an ill-ulcerative mass measuring 6 cm × 4 cm × 0.5 cm with gray-to-brown coloration and extensive necrosis with perforation; the mass was located 15 and 7 cm in length from the bilateral cut ends. In addition, focal vascular proliferation, and infiltrate deeply to the serosa with mesenteric enlarged lymph nodes were observed. Furthermore, the mesenteric regional lymph nodes show metastatic sarcoma. The definitive diagnosis was based on the findings of histomorphology, immunohistochemistry, and molecular pathology.

Primary Ewing Sarcoma of Vulva: A Case Report and a Review of Literature

IntroductionEwing sarcoma family of tumour represents a group of bone and soft-tissue tumours with variable neuroectodermal differentiation. Extraosseous Ewing sarcoma (EES) commonly arises in soft tissues of trunk or extremities with a few reported rare sites include larynx, nasal cavity, neck, lung, retroperitoneum, mediastinum and genital tract. Till now 28 cases of extraosseous Ewing sarcoma of vulva and vagina have been reported in the literature.Case ReportWe report 29th case of Ewing sarcoma vulva in sixth youngest, 16-year-old patient with third largest size tumour. Her all routine blood reports were found to be normal, and MRI showed highly vascular vulval mass with terminal urethral involvement. Tru-cut biopsy revealed uniform sheets of small round cells with geographical necrosis and perivascular clusters of tumour cells. Immunohistochemical staining demonstrated that the cells were focally positive for CK and vimentin and showed membranous positivity for CD99 and nuclear positivity for FLI1, whereas all other IHC markers to rule out differentials of small round cell tumour were negative. Based on HPE and IHC, which is polyimmunophenotypic, has confirmed the diagnosis of an ES/PNET. After ruling out for the metastatic lesions, 14 cycles of chemotherapy with compressed VDC/IE were planned, but after receiving her 1st cycle itself, she expired on 10th day of post-chemotherapy.ConclusionEES is a rare fast growing aggressive tumour requiring ancillary techniques for exact diagnosis and multimodality treatment for better survival.

Extraosseous Ewing Sarcoma: Expanding the Differential Diagnosis of Supraclavicular Fossa Tumors

A broad spectrum of diseases can be included in the differential diagnosis of neck masses. We report a case of extraosseous Ewing sarcoma that presented as a neck mass in a 70-year-old man. To the best of our knowledge, this is the first reported case of extraosseous Ewing sarcoma of the supraclavicular fossa. Published cases of extraosseous Ewing sarcoma in the neck have been described in other age groups, but those tumors were confined to the parapharyngeal space. Also, there have been reported cases in patients older than 70 years in which Ewing sarcoma affected other structures such as the larynx and the pelvis, but none in the soft tissues of the neck. This case adds extraosseous Ewing sarcoma as a possible diagnosis to consider when evaluating a neck mass in the supraclavicular fossa.

A rare case of extraosseous Ewing sarcoma primarily arising in the ovary

A rare case of extraosseous Ewing sarcoma primarily arising in the ovary

Localized extraosseous Ewing’s sarcoma of the chest wall resected by video-assisted thoracoscopic surgery

Extraosseous Ewing's sarcoma (ES) is a small round cell tumor arising in soft tissue that was undifferentiated histologically from classic ES of bone. It frequently affects children and adolescents, with an unfavorable prognosis. Herein, we report a case of localized extraosseous ES of the chest wall resected by video-assisted thoracoscopic surgery (VATS). An asymptomatic 40-year-old man presented with an abnormal shadow on chest radiography. Chest computed tomography showed a 1.5-cm solid tumor on the chest wall. VATS was undertaken for the undiagnosed tumor. Thoracoscopic findings showed a hemispheric tumor with a smooth surface on the chest wall. The tumor was diagnosed with an extraosseous ES by pathological and cytogenetic examinations. As adjuvant therapy, the patient was treated with radiotherapy, followed by multiagent chemotherapy. There have been few reported cases in which VATS was used for extraosseous ES of chest wall, so our case was thought to be very rare.

Extraosseous Ewing sarcoma of the thyroid gland

Ewing sarcoma of the bone is a highly malignant round-cell tumor that typically presents between 10 to 20 years of age and is more common in boys. It can have an extraosseous origin, although it is rare. We report a case of extraosseous Ewing sarcoma in the thyroid gland in a 9-year-old girl.

Intracranial Ewing sarcoma

The occurrence of primary extraosseous Ewing sarcoma (EES) of the central nervous system (CNS) has only rarely been reported in the literature. It is important to distinguish this entity from the more common central primitive neuroectodermal tumor (PNET) of brain, since the management of these tumors is different from that of EES. We present the clinical, radiologic, and pathologic features of two cases of EES occurring in the brain. The diagnosis was further confirmed by detection of a rearrangement of the FLI1 and/or EWS gene loci in tumors from both patients using fluorescent in situ hybridization (FISH). Although rare, the possibility of EES should be considered particularly when tumors that arise near the meningeal surface of the brain and have the pathologic appearance of a PNET. Demonstration of t(11;22)(q24;q12) by molecular analysis essentially confirms the diagnosis and enables the oncologist to choose appropriate therapy.

Fine Needle Aspiration Cytology of the Ewing’s Sarcoma Family of Tumors

To study the cytomorphologic features of the Ewing's sarcoma (ES) family of tumors. During a period of eight years (1990-1997), 123 soft tissue tumors and 65 bone tumors were evaluated by fine needle aspiration cytology (FNAC); 14 cases were diagnosed as in the ES family of tumors. The ages of the patients ranged from 8 to 30 years. All the cases were histologically confirmed. Of 14 cases of the ES family of tumors, 7 were ES, 3 extraosseous ES (EOE), 2 peripheral primitive neuroectodermal tumor (PPNET) and 2 Askin tumor. Cytologically, smears from all the cases showed round tumor cells with a high nuclear/cytoplasmic ratio. On detailed examination, subtle differentiating features were observed. The cells in ES had finer nuclear chromatin in comparison to those of PPNET and Askin tumor, and punched-out clear cytoplasmic vacuoles were present. PPNET showed nuclear molding, unipolar cytoplasmic tags and Homer-Wright rosettes. Histologically, all cases of ES and EOE and one case of Askin tumor showed periodic acid-Schiff-positive inclusions. FNAC features coupled with clinical findings enable a rapid diagnosis of the ES family of tumors, from which treatment modalities can be determined.