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Fedeli MA, Marras V, Fara AM, Deiana A, Lobrano R, Cossu A, Paliogiannis P. Primary Ewing sarcoma of the lung: A systematic review of the recent literature. Ann Diagn Pathol 2023; 65:152152. [PMID: 37149954 DOI: 10.1016/j.anndiagpath.2023.152152] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/24/2023] [Accepted: 04/25/2023] [Indexed: 05/09/2023]
Abstract
Primary pulmonary Ewing sarcoma (PES) is a rare malignancy with only sporadic cases reported in the scientific literature. We performed a systematic review of the cases published in the last decade on PubMed, with the aim to describe the clinical, pathological, therapeutic, and prognostic data of PES. Forty-two articles reporting on 50 cases have been reviewed. Globally, 60 % of the patients were males, and the mean age at diagnosis was 30.5 years, with only a few cases diagnosed after 50 years of age. The most common clinical manifestations at diagnosis were dyspnea, cough and chest pain. The most common immunohistochemistry findings were staining for CD99 and (less frequently) for vimentin, and no staining for TTF-1, cytokeratin, desmin and S-100. ESWR1-FL1 translocation was tested in less than half of the cases. The disease was often locally advanced, treated generally with multidisciplinary treatment combining surgery, chemotherapy and radiation therapy. Among patients with follow-up data, approximately 40 % were dead at the time of publication, with the median survival being 11.5 months. Among those who were alive, only 8.3 % was free from disease at 48 months from diagnosis.
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Affiliation(s)
- Maria Antonietta Fedeli
- Unit of Anatomic Pathology and Histology, University Hospital of Sassari (A.O.U. SS), Via Matteotti 60, 07100 Sassari, Italy
| | - Vincenzo Marras
- Unit of Anatomic Pathology and Histology, University Hospital of Sassari (A.O.U. SS), Via Matteotti 60, 07100 Sassari, Italy
| | - Antonella Maria Fara
- Unit of Anatomic Pathology and Histology, University Hospital of Sassari (A.O.U. SS), Via Matteotti 60, 07100 Sassari, Italy
| | - Angelo Deiana
- Unit of Anatomic Pathology and Histology, University Hospital of Sassari (A.O.U. SS), Via Matteotti 60, 07100 Sassari, Italy
| | - Renato Lobrano
- Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Antonio Cossu
- Unit of Anatomic Pathology and Histology, University Hospital of Sassari (A.O.U. SS), Via Matteotti 60, 07100 Sassari, Italy; Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy
| | - Panagiotis Paliogiannis
- Unit of Anatomic Pathology and Histology, University Hospital of Sassari (A.O.U. SS), Via Matteotti 60, 07100 Sassari, Italy; Department of Medicine, Surgery and Pharmacy, University of Sassari, Viale San Pietro 43, 07100 Sassari, Italy.
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Primary bronchial Ewing sarcoma. Int J Surg Case Rep 2019; 61:230-233. [PMID: 31377551 PMCID: PMC6698311 DOI: 10.1016/j.ijscr.2019.07.062] [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: 06/11/2019] [Revised: 07/19/2019] [Accepted: 07/20/2019] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Primary bronchial Ewing sarcoma (ES) is a rare endobronchial tumor. PRESENTATION OF CASE A 65-year-old male presented with six-month history of progressive shortness of breath. Flexible bronchoscopy showed an endobronchial polypoid tumor in the left main stem bronchus about 2 cm from the carina. The tumor was resected by a left bronchial sleeve resection using a right postero-lateral thoracotomy approach. Pathology showed complete tumor resection with negative margins. The morphological and immune-phenotypical features of the resected specimen were compatible with ES. He had an uneventful post-operative recovery. He did not receive adjuvant radiation or chemotherapy and remains disease free at 9 months follow up. DISCUSSION A review of the literature identified six other cases of primary bronchial ES. In addition, there were three reported cases of primary ES involving the trachea and thirteen involving the lung parenchyma. Bronchial ES appeared to have a relatively better prognosis than ES involving the trachea or the lung. Our case demonstrates that primary bronchial ES may be treated safely with limited resection, lung preservation and without the need for adjuvant therapy if negative margins can be achieved. CONCLUSION Sleeve resection without adjuvant therapy may be a safe treatment option for primary bronchial ES.
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Chen J, Yuan T, Liu X, Hua B, Dong C, Liu Y, Quan G. Ewing's Sarcoma/Peripheral Primitive Neuroectodermal Tumors in Bronchus. Am J Med Sci 2018; 357:75-80. [PMID: 30314832 DOI: 10.1016/j.amjms.2018.08.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 07/03/2018] [Accepted: 08/15/2018] [Indexed: 11/19/2022]
Abstract
Ewing sarcoma/peripheral primitive neuroectodermal tumors (ES/pPNET), a member of the Ewing sarcoma family of tumors, is a malignant soft tissue tumor with small undifferentiated neuroectodermal cells. Primary trachea-bronchial ES/pPNET is very rare. The most common pulmonary ES is due to a metastasis. We describe a case of ES/pPNET which originated in the left basal trunk bronchus. The patient was a 30-year-old male, presenting with irritable cough and fever for 10 days. A tumor of 60 mm in diameter was found in the left basal trunk bronchus, extending to the left lower lobe. No distant metastases were detected. Histopathological examination revealed a malignancy of ES/pPNET with a diffuse proliferation of round cells, a Flexner-Wintersteiner rosette formation and positive staining for CD99. The patient was successfully treated with a combination of left lower lobectomy and adjuvant chemotherapy and has remained disease-free for approximately 18 months at follow-up. This case highlights that ES/pPNET should be considered as a differential diagnosis in cases of trachea-bronchial tumors.
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MESH Headings
- Adult
- Bronchi/pathology
- Bronchial Neoplasms/diagnosis
- Bronchial Neoplasms/diagnostic imaging
- Bronchial Neoplasms/drug therapy
- Bronchial Neoplasms/surgery
- Humans
- Male
- Neuroectodermal Tumors, Primitive, Peripheral/diagnosis
- Neuroectodermal Tumors, Primitive, Peripheral/diagnostic imaging
- Neuroectodermal Tumors, Primitive, Peripheral/drug therapy
- Neuroectodermal Tumors, Primitive, Peripheral/surgery
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/diagnostic imaging
- Sarcoma, Ewing/drug therapy
- Sarcoma, Ewing/surgery
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Affiliation(s)
- Jun Chen
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tao Yuan
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xiao Liu
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bei Hua
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chenfeng Dong
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yawu Liu
- Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland; * Now Jun Chen works in The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guanmin Quan
- Department of Medical imaging, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
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Wineland AM, Turpin B, Gupta A, de Alarcon A. Ewing Sarcoma in the cervical trachea of a pediatric patient: A case report and review of the literature. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Puthusseri J, Narayanan G, Preethi TR, Jayapriya G. Ewing's sarcoma of the trachea in an adolescent girl. Proc (Bayl Univ Med Cent) 2017; 30:325-326. [PMID: 28670073 DOI: 10.1080/08998280.2017.11929634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Primitive neuroectodermal tumors (PNET) are aggressive neoplasms of neuroectodermal origin. Although they are known to arise in a host of locations, involvement of the trachea has rarely been reported. We describe an adolescent girl who presented with stridor and was diagnosed with PNET of the trachea. She is in remission following treatment with combination chemotherapy and local radiotherapy.
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Affiliation(s)
- Jaisankar Puthusseri
- Departments of Medical Oncology (Puthusseri, Narayanan) and Pathology (Preethi, Jayapriya), Regional Cancer Center, Trivandrum, India
| | - Geetha Narayanan
- Departments of Medical Oncology (Puthusseri, Narayanan) and Pathology (Preethi, Jayapriya), Regional Cancer Center, Trivandrum, India
| | - T R Preethi
- Departments of Medical Oncology (Puthusseri, Narayanan) and Pathology (Preethi, Jayapriya), Regional Cancer Center, Trivandrum, India
| | - G Jayapriya
- Departments of Medical Oncology (Puthusseri, Narayanan) and Pathology (Preethi, Jayapriya), Regional Cancer Center, Trivandrum, India
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