Case Of Primary Ewing's Sarcoma Research Articles

Primary and Metastatic Pancreatic Ewing Sarcomas: A Case Report and Review of the Literature.

Ewing sarcomas are rare tumors arising mainly in the bones and the surrounding soft tissues. Primary extraosseous Ewing sarcomas have also been described in several other organs and locations other than bones, including the pancreas. These tumors have well-defined histological, immunohistochemical, and molecular characteristics. In this manuscript, we present a case of primary Ewing sarcoma of the pancreas in a 29-year-old patient, and we systematically review the literature on both primary and metastatic Ewing sarcomas of the pancreas, describing their clinicopathological characteristics. We also discuss the differential diagnosis and the treatment of this rare entity.

A MAXILLARY LESION WITH A RARE DIAGNOSIS; A CASE REPORT OF EWING SARCOMA

Objectives Primary Ewing sarcoma of the head and neck is rare, representing only 3% of all Ewing sarcoma cases. The aim is to present a rare case of maxillary location of a Ewing sarcoma. Case report A 23-year-old male patient presented with a chief complaint of upper lip swelling attributed to a cystic lesion in the apical area left lateral maxillary incisor. Imaging showed an apical lesion of this tooth, indicating a broad osteolytic location. The lesion was removed, and a sample was taken for biopsy. The immunohistochemical findings agreed with a malignant bone tumor that exhibits features more compatible with the diagnosis of Ewing’s Sarcoma. The patient underwent chemotherapy and radiotherapy. No signs of recurrence can be seen five years after treatment. Conclusions Most of the few published cases of primary Ewing sarcoma of the maxillary have been diagnosed as cystic lesions. Early diagnosis of head and neck Ewing sarcoma is essential for operating R0 surgeries that may not require radiotherapy. Each case's severity and needs should be evaluated to select the appropriate treatment regimen.

A Case of Primary Ewing Sarcoma of the Strap Muscle

A Case of Primary Ewing Sarcoma of the Strap Muscle

Primary Ewing Family of Tumors of the Jaw Has a Better Prognosis Compared to Tumors of Extragnathic Sites

Primary Ewing sarcoma of the jaw is rare. The aim of this study was to describe new cases of primary Ewing sarcoma of the jaw and investigate reported prognostic factors of Ewing sarcoma in this series and treatment outcome. Six patients with primary Ewing sarcoma of the jaw were treated at the Memorial Sloan Kettering Cancer Center (MSKCC) from 1992 through 2013. Clinical data, pathology reports, treatment prescribed, treatment regimens, outcome, and follow-up information were reviewed. Five of 6 patients were female and 5 cases were in the mandible. No patient presented with metastatic disease at diagnosis. All cases were positive for CD99, and 3 patients with genetic confirmation were positive for EWS-FLI1 fusion or EWSR1 gene rearrangement. All patients received induction multiagent chemotherapy and surgical resection and 2 patients received adjuvant radiotherapy. Total (grade IV) or nearly total (grade III) tumor necrosis in 3 of 5 patients (60%) assessed for histologic response to chemotherapy indicated intense sensitivity. All patients were alive and free of disease, with no history of local recurrence, at a median follow-up period of 6.5years. Patients with primary Ewing sarcoma of the jaw have a good prognosis and metastasis is an uncommon occurrence at initial presentation.

MB-07 * PRIMARY EWING SARCOMA OF THE SCALP WITH APPARENT EPIDURAL EXTENSION: CASE ILLUSTRATION

INTRODUCTION: Ewing sarcoma is an aggressive, rapidly growing, malignant tumor originating from postganglionic parasympathetic neural crest cells, most commonly originating in the pelvis and long bones. We describe a rare case of primary Ewing sarcoma of the scalp, in which imaging was suggestive of intracranial extension not seen on operative exploration. CASE REPORT: An 11 year old boy with a rapidly growing subcutaneous mass on the forehead was diagnosed with Ewing sarcoma by needle biopsy. Brain CT and MRI showed an extracranial mass with a smaller corresponding epidural lesion. Metastatic evaluation was negative. The patient was treated with chemotherapy to shrink the lesion, followed by surgical resection of the residual mass. In surgery, only partial-thickness erosion of the extracranial tumor mass through the bone was observed. The involved area of skull with margins was removed as a single bone flap. The inner table of the bone and epidural space appeared grossly normal, and there was no subdural mass on ultrasound. The patient subsequently completed further chemotherapy and radiation, and has remained disease-free. No residual or recurrent abnormal tissue has been seen on surveillance imaging. DISCUSSION: Ewing sarcoma of the scalp is a rarely reported disease entity, relatively less common than primary disease of the skull. Good outcomes have been reported when wide local excision is carried out. The phenomenon of radiographic epidural pseudoextension has not previously been described and does not seem to have adversely affected outcome in this case. CONCLUSIONS: MRI may overestimate extent of disease in cases adjacent to the epidural space. In cases of localized disease, wide local excision combined with chemotherapy and radiation can offer significant progression-free survival.

Primary Ewing Sarcoma of the Kidney with Inferior Vena Cava Invasion

Ewing sarcoma is typically a skeletal based tumor of presumed neuroectodermal origin. Primary Ewing sarcoma of the kidney is exceedingly rare and is usually found in young adults. We report a case of primary Ewing sarcoma with inferior vena cava (IVC) invasion that was managed successfully with radical nephrectomy and partial replacement of IVC using bovine pericardial patch.

Primary Ewing Sarcoma of the Spine Mimicking a Psoas Abscess Secondary to Spinal Infection

A case of primary Ewing sarcoma of the lumbar spine is presented. To present and review a rare case of primary Ewing sarcoma of the lumbar spine that required differentiation from spinal infection. Primary Ewing sarcoma originating from the spinal column is very rare. Because Ewing sarcoma is one of the most aggressive bone tumors with high proliferative and invasive potential, its clinical symptoms and variety of imaging manifestations can mimic the pathologic findings of other diseases, including infectious diseases. The clinical course, radiologic features, pathology and treatment outcome of a patient with primary Ewing sarcoma of the lumbar spine was documented. The magnetic resonance imaging findings showed an abnormal marrow signal at the L2 vertebra and significant enlargement of the unilateral iliopsoas muscle. Immunologic and molecular analysis of the surgical specimen provided a diagnosis of Ewing sarcoma. Laminotomy followed by multidisciplinary therapy including chemotherapy and radiation therapy was effective for treating this case. We report a case of Ewing sarcoma that mimicked a psoas abscess secondary to spinal infection. Abnormal magnetic resonance imaging images, as well as a confusing clinical course, made diagnosis difficult. When enlargement of the iliopsoas with a vertebral lesion is detected in a child with low back pain, Ewing sarcoma should be included in the differential diagnosis.

Extraskeletal Ewing sarcoma of the diaphragm presenting with hemothorax

Ewing sarcoma is a relatively uncommon malignant bone neoplasm that usually occurs in children and young adults and involves the major long bones, pelvis, and ribs. Primary diaphragmatic Ewing sarcoma is extremely rare. To the best of our knowledge, only three cases of primary Ewing sarcoma of the diaphragm have been reported. A 12-year-old girl presented spontaneous occurrences of the right hemothorax. After drainage, a roentgenogram film, computed tomography, ultrasonography, and magnetic resonance image showed a giant mass on the right diaphragm. Primary diaphragmatic tumor was resected totally by right posterolateral thoracotomy, and histologically, an extraskeletal Ewing sarcoma was identified. The patient received adjuvant radio-chemotherapy, and there was no evidence of disease 10 months after the operation. Although extremely rare, extraskeletal Ewing sarcoma should be kept in mind in the differential diagnosis of diaphragmatic soft tissue tumors.

Primary Ewing sarcoma: follow-up with Ga-67 scintigraphy.

While avid accumulation of gallium-67 citrate and technetium-99m methylene diphosphonate (MDP) occurs initially in most cases of primary Ewing sarcoma, uptake after therapy is less well defined. Thirty patients with Ewing sarcoma who underwent Ga-67 and bone scintigraphy at diagnosis, at completion of therapy, and at relapse from 1978 to 1988 were evaluated. All 30 patients showed less primary site Ga-67 activity following therapy. Twenty-three of 28 patients who underwent corresponding bone scintigraphy showed less uptake, but residual activity was usually more intense than with Ga-67. Avid reaccumulation of Ga-67 occurred in four of five patients with primary site relapse, while patients who underwent bone scintigraphy showed less change. It was concluded that a greater decrease in Ga-67 than in Tc-99m MDP uptake often occurs in patients successfully treated for primary Ewing sarcoma. Information obtained at Ga-67 scintigraphy is most likely to be helpful if results of bone scintigraphy remain abnormal or if occult relapse is suspected.

Ewing Sarcoma of the Skull with an Unusual Pattern of Reactive Sclerosis

A case of primary Ewing sarcoma involving the occipital bone with an unusual radiographic feature--markedly thickened bone--is described. Magnetic resonance imaging was more helpful than CT in determining the lesion extent due to lack of bone artifact and since it showed the precise relationship of the neoplasm to the tentorium on direct coronal imaging.