Abstract
Background: Ewing sarcoma (ES), a rare bone tumor primarily affecting adolescents and young adults, exhibits aggressive
behavior, typically originating from bones or nearby soft tissues.
Histopathology reveals a small round cell tumour, posing a challenge in distinguishing from small cell carcinoma, sarcomas, or
lymphoma. This report outlines a 20-year-old man’s case of lumbar spine ES with lung metastases.
1.2. Case Report: A 20-year-old male complained of back pain
radiating to both legs, particularly the right. No signs of paralysis were evident. Magnetic Resonance Imaging revealed a lumbar mass with extradural spread in the spinal canal, compressing
the dural sac and extending through the intervertebral foramen,
auto necrosis areas were identified which led to working diagnosis
of Schwannoma. The surgical extraction of the lumbar mass was
performed. Immunohistochemical analysis of operative material
revealed small round tumour cells with CD99 positivity. Subsequently, a t (11; 22) (q24.3; q12.2) translocation was identified,
confirming the histopathological diagnosis of Ewing sarcoma. Two
months post-surgery, lung metastases and hypermetabolism in L2
vertebra, spinal cord, and TH11-TH12 tissue were detected. The
next step in the patient’s treatment plan involves chemotherapy.
1.3. Conclusion: Ewing’s sarcoma, a fast-growing malignancy,
requires a multidisciplinary approach due to its clinical and radiographic features. This report underscores the challenge of distinguishing primary bone Ewing sarcoma from bone metastasis of
other small round cell malignancies. The tumour’s unusual location may complicate diagnosis, potentially leading to confusion
with schwannoma. Early, precise diagnosis is crucial for prompt
treatment
behavior, typically originating from bones or nearby soft tissues.
Histopathology reveals a small round cell tumour, posing a challenge in distinguishing from small cell carcinoma, sarcomas, or
lymphoma. This report outlines a 20-year-old man’s case of lumbar spine ES with lung metastases.
1.2. Case Report: A 20-year-old male complained of back pain
radiating to both legs, particularly the right. No signs of paralysis were evident. Magnetic Resonance Imaging revealed a lumbar mass with extradural spread in the spinal canal, compressing
the dural sac and extending through the intervertebral foramen,
auto necrosis areas were identified which led to working diagnosis
of Schwannoma. The surgical extraction of the lumbar mass was
performed. Immunohistochemical analysis of operative material
revealed small round tumour cells with CD99 positivity. Subsequently, a t (11; 22) (q24.3; q12.2) translocation was identified,
confirming the histopathological diagnosis of Ewing sarcoma. Two
months post-surgery, lung metastases and hypermetabolism in L2
vertebra, spinal cord, and TH11-TH12 tissue were detected. The
next step in the patient’s treatment plan involves chemotherapy.
1.3. Conclusion: Ewing’s sarcoma, a fast-growing malignancy,
requires a multidisciplinary approach due to its clinical and radiographic features. This report underscores the challenge of distinguishing primary bone Ewing sarcoma from bone metastasis of
other small round cell malignancies. The tumour’s unusual location may complicate diagnosis, potentially leading to confusion
with schwannoma. Early, precise diagnosis is crucial for prompt
treatment
| Original language | English |
|---|---|
| Article number | 7 |
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | American Journal of Surgery and Clinical Case Reports |
| Volume | 7 |
| Issue number | 13 |
| DOIs | |
| Publication status | Published - 12 Mar 2024 |
Keywords*
- Ewings Sarcoma
- Magnetic Resonance Imaging
- Lumbar Region
- Metastases
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 1.4. Reviewed scientific article published in Latvia or abroad in a scientific journal with an editorial board (including university editions)