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Gore MR. Treatment, Survival, and Demographics in Temporal Bone Malignancies: A Pooled Data Analysis. Cureus 2022; 14:e31973. [DOI: 10.7759/cureus.31973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 11/29/2022] Open
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2
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Mohindra S, Tripathi M, Batish A, Kapoor A, Patil NR, Mahendru S, Ahuja C, Chatterjee D. Primary Calvarial Ewing Sarcoma: A Case Series. Skull Base Surg 2022; 83:e181-e190. [DOI: 10.1055/s-0041-1722900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 12/07/2020] [Indexed: 10/22/2022]
Abstract
Abstract
Background Calvarial Ewing tumor is a relatively rare differential among bony neoplasms. We present our experience of managing primary calvarial Ewing sarcoma (EWS), highlighting their clinical and radiological findings.
Method In a retrospective analysis, we evaluated our 12-year database for pathologically proven EWS. A literature search was conducted for the comparative presentation and update on the management and outcome.
Result From January 2008 to December 2020, we managed eight patients (male:female = 5:3; age range 6 months to 19 years, mean 11.5 years) harboring primary calvarial EWS. All cases underwent wide local excision; two patients required intradural tumor resection, while one required rotation flap for scalp reconstruction. Mean hospital stay was 8 days. All patients received adjuvant chemo- and radiotherapy. Three patients remained asymptomatic at 5 years of follow-up, while two patients died.
Conclusion Primary calvarial EWS is a rare entity. It usually affects patients in the first two decades of life. These tumors can be purely intracranial, causing raised intracranial pressure symptoms, which may exhibit rapidly enlarging subgaleal tumors with only cosmetic deformities or symptoms of both. Radical excision followed by adjuvant therapy may offer a favorable long-term outcome.
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Affiliation(s)
- Sandeep Mohindra
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manjul Tripathi
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aman Batish
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ankur Kapoor
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ninad Ramesh Patil
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shaurya Mahendru
- Medical Undergraduate, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Chirag Ahuja
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Debajyoti Chatterjee
- Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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3
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Choi SW, Ko H. Primary Ewing sarcoma of the squamous temporal bone with intracranial and extracranial extension: A rare cause of sudden sensorineural hearing loss. Head Neck 2018; 41:E38-E41. [DOI: 10.1002/hed.25449] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Accepted: 08/15/2018] [Indexed: 11/11/2022] Open
Affiliation(s)
- Sung-Won Choi
- Department of Otorhinolaryngology and Biomedical Research Institute; Pusan National University Hospital; Busan Republic of Korea
| | - Hoon Ko
- Department of Pediatrics and Biomedical Research Institute; Pusan National University Yangsan Hospital; Yangsan Republic of Korea
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Sarigul B, Uysal E, Avci İ, Peker H, Celik S. Giant Calvarial Ewing's Sarcoma: A Case Report. J Neurol Surg Rep 2018; 79:e79-e82. [PMID: 30302304 PMCID: PMC6173587 DOI: 10.1055/s-0038-1673626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 08/28/2018] [Indexed: 01/18/2023] Open
Abstract
Ewing's sarcoma (EWS) is the second most common primary bone tumor seen in children and adolescents, first being osteosarcoma. Skull lesions are seen in 6 to 9% of cases. The tumor tends to reside most frequently on frontal and parietal bones. In the literature, majority of papers on calvarial EWS present cases with intracranial involvement; extracranial extension is reported in only eight cases. The case that we are presenting in this report is a 23-year-old male patient with multiple infiltrations in femur, costal bones, and calvarium which had been diagnosed radiologically and histopathologically as EWS. The calvarial metastasis had reached a very huge size with dimensions of approximately 7.5 × 7.5 × 9.5 cm and was successfully excised totally. Twelve months of follow-up revealed no recurrence in the surgical site showing that total removal of giant cranial EWS may improve morbidity of these patients.
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Affiliation(s)
- Buse Sarigul
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
| | - Ece Uysal
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
| | - İdris Avci
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
| | - Halil Peker
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
| | - Suat Celik
- Department of Neurosurgery, Okmeydani Education Hospital, Istanbul, Turkey
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Abstract
Ewing sarcoma (EWS) is a primitive neuroectodermal tumor arising in bone or soft tissue. It is the second most common primary bone malignancy of children and adolescents, with a peak incidence in the second decade of life. It most often arises in the long bones of the extremities and pelvis. Here, we present a novel case of EWS arising from the mastoid bone in a 5-year-old African American male who presented with symptoms of acute mastoiditis. This unique presentation highlights the importance of considering EWS in a patient who presents with atypical mastoiditis or a rapidly growing mass in the postauricular region.
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6
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Gupta D, Gulati A, Purnima. Primary Ewing's Sarcoma of the Temporal Bone: A Rare Case Report and Literature Review. Indian J Otolaryngol Head Neck Surg 2017; 69:415-419. [PMID: 28929078 PMCID: PMC5581752 DOI: 10.1007/s12070-015-0942-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Accepted: 12/07/2015] [Indexed: 11/25/2022] Open
Abstract
Ewing's sarcoma is a malignant, round cell tumor arising from the bones and primarily affecting children and adolescent, accounting for 3 % of all childhood malignancies. Although the long bones and the trunk are typically affected, rare cases of it involving isolated bones throughout the body have been reported. Involvement of the skull bones is rare, constituting 1-6 % of the total Ewing's sarcoma cases but those affecting the cranial bones are rarer still, constituting only 1 %. We describe an 8 months old infant having Ewing sarcoma, of the petrous and mastoid parts of temporal bone along with the occipital bone, whose clinical presentation mimicked mastoiditis with facial nerve palsy. We discuss the clinical and therapeutic course of an extensive primary Ewing sarcoma of the temporal bone, which was treated without performing surgery and review this entity's literature in detail.
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Affiliation(s)
- Divya Gupta
- Department of Otorhinolaryngology and Head and Neck Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, 110002 India
- 66, Raj Nagar, Pitam Pura, Delhi, 110034 India
| | - Achal Gulati
- Department of Otorhinolaryngology and Head and Neck Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, 110002 India
| | - Purnima
- Department of Otorhinolaryngology and Head and Neck Surgery, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, 110002 India
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7
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Narayanan G, Sreelesh KP, Somanathan T, Soman LV. Ewing's Sarcoma of the Cranial Vault. J Neurosci Rural Pract 2017; 7:S109-S111. [PMID: 28163522 PMCID: PMC5244040 DOI: 10.4103/0976-3147.196464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary Ewing's sarcoma (EWS) arising from cranial bones is rare and accounts for only 1%–4% of all EWS. We report the case of a 15-year-old girl with EWS of the frontoparietal region of the skull. She underwent excision following which she received combination chemotherapy with vincristine, doxorubicin, cyclophosphamide alternating with ifosfamide, and VP16 and local radiation of 45 Gy. She is alive in complete remission at 40 months.
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Affiliation(s)
- Geetha Narayanan
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - K P Sreelesh
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Thara Somanathan
- Department of Pathology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Lali V Soman
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
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8
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Subtemporal-anterior transtentoral approach to middle cranial fossa microsurgical anatomy. J Craniofac Surg 2014; 25:2220-2. [PMID: 25377976 DOI: 10.1097/scs.0000000000001073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This study aimed to describe the topography of inferior and external dura mater of the middle cranial fossa through subtemporal-anterior transpetrosal approach and discuss the feasibility of improving the approach. Eight formalin-fixed adult cadaveric heads were studied, with the bones milled away in the lateral triangle region of the petrous bone, Kawase rhombus region, and inner triangle region of the petrous apex. The distances between the targets in these regions, as well as the angles after the dissection of zygomatic arch, were measured, and then the exposed petroclival and retrochiasmatic areas were observed under the microscope. There were significant variations in the distances between targets in the 3 milled regions among the specimens. After the dissection of zygomatic arch, the surgical view got an average increase of 12 degrees. The subtemporal anterior transpetrosal approach, as an improved subtemporal approach, can expose the lesions optimally, causing no injury to the hearing and reducing injuries to temporal lobe. On the other hand, the lateral bone of the petrous parts of the temporal bone is removed so as to improve the view to the retrochiasmatic area and expand the operative field.
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Rahman A, Bhandari PB, Hoque SU, Wakiluddin ANM. Primary Ewing's sarcoma of the skull. BMJ Case Rep 2013; 2013:bcr2012007979. [PMID: 23370949 PMCID: PMC3604190 DOI: 10.1136/bcr-2012-007979] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ewing's sarcoma, a highly malignant bone tumour, typically affects the pelvis and the long bones of the lower extremities in children and young adults and primary involvement of the skull is rare. Here, we present a case of primary Ewing's sarcoma of the skull with localised swelling in a young adult that involved the frontoparietal region of the skull and was very aggressive in nature. Even with aggressive surgery, the patient had multiple recurrences within 1 month of surgery and ultimately the patient died.
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Affiliation(s)
- Asifur Rahman
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
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Kadar AA, Hearst MJ, Collins MH, Mangano FT, Samy RN. Ewing's Sarcoma of the Petrous Temporal Bone: Case Report and Literature Review. Skull Base 2011; 20:213-7. [PMID: 21318041 DOI: 10.1055/s-0029-1246224] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Ewing's sarcoma, which accounts for 6 to 9% of malignant bone neoplasms in children, typically affects the trunk and long bones and less often affects the skull (i.e., maxilla, frontal, parietal, ethmoid, temporal bones). Adding to literature of five previously reported cases, we now describe the case of the oldest child, a 16-year-old boy, with a primary Ewing's sarcoma of the petrous temporal bone. When this patient presented after 1 week of right-sided facial paralysis and new-onset headache, imaging studies showed a mass that originated in the right petrous temporal bone. During biopsy and surgical excision, the mass was found to involve the facial nerve, which then required nerve grafting. Postoperatively, he then underwent radiotherapy with both induction and adjuvant chemotherapy. Although an uncommon tumor of the temporal bone, physicians should consider Ewing's sarcoma in the differential diagnosis of children and adolescents who present with facial nerve paralysis.
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Affiliation(s)
- Aleem A Kadar
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Neuroscience Institute and UC College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
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Abstract
Ewing's sarcoma is a highly malignant neoplasm of bones which accounts for the 10% of primary bone malignancies. Primary Ewing's sarcoma of skull vault is very rare and constitutes 1-6% of all Ewing's sarcomas. We present a case of a primary and a radiation-induced skull Ewing's sarcoma. The symptoms, neuroimaging findings and the treatment for these cases are reviewed. Both children were operated with favorable outcome.
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De Foer B, Kenis C, Vercruysse JP, Somers T, Pouillon M, Offeciers E, Casselman JW. Imaging of Temporal Bone Tumors. Neuroimaging Clin N Am 2009; 19:339-66. [DOI: 10.1016/j.nic.2009.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sato S, Mitsuyama T, Ishii A, Kawakami M, Kawamata T. Multiple primary cranial Ewing's sarcoma in adulthood: case report. Neurosurgery 2009; 64:E384-6; discussion E386. [PMID: 19190443 DOI: 10.1227/01.neu.0000337128.67045.70] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Ewing's sarcoma is a malignant bone tumor occurring most frequently in the long bones and flat bones as a solitary lesion during the first 2 decades of life. Ewing's sarcoma and peripheral primitive neuroectodermal tumor have recently been considered to be the same entity because of histological and molecular similarities. CLINICAL PRESENTATION A 25-year-old man presented with swelling in the right parietal region. Magnetic resonance imaging scans showed 2 mixed intense mass lesions in the right parietal and left frontal areas with heterogeneous gadolinium enhancement. A computed tomographic scan revealed osteolytic changes of the inner calvarial bone. Ga-67 citrate scintigraphy demonstrated abnormal uptake in the right parietal and the left frontal areas consistent with the findings on magnetic resonance imaging scans. There was no uptake lesion beyond the cranium. The patient underwent surgical excision of the right parietal lesion. INTERVENTION Histological examinations showed densely packed, small round cells with rosette formation. The cells had scanty clear cytoplasm, and regular vesicular and hyperchromatic nuclei. Electron microscopy showed little differentiation to neuronal tissue, indicating Ewing's sarcoma. After surgical treatment, conventional whole cranial irradiation of 40 Gy and chemotherapy were conducted. The tumor in the left frontal region disappeared. Follow-up examinations showed no evidence of recurrence 1 year after the surgery. CONCLUSION Although quite rare, Ewing's sarcoma should be taken into consideration as a differential diagnosis of multiple cranial mass lesions in adulthood.
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Affiliation(s)
- Shinsuke Sato
- Department of Neurosurgery, Tokyo Women's Medical University, Yachiyo Medical Center, Chiba, Japan
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