Case report of an ewing's sarcoma/primitive neuroectodermal tumor of the kidney

Experience of CT diagnosis and management of primary renal Ewing's sarcoma: A retrospective analysis of 6 cases and a literature review

To present the clinical experience of primary renal Ewing's sarcoma/primitive neuroectodermal tumors (rEWs/PNET) admitted to our hospital and systematically review the published literature. A retrospective analysis was performed on patients with pathologically confirmed renal EWs/PNET (rEWs) in our hospital, and the literature on rEWs published in PubMed and Embase databases before March 1, 2022 was searched for analysis. A total of 337 rEWs were included in the statistical analysis, including 6 cases of our patients and 331 cases published in the literature. The common clinical symptoms of rEWs are abdominal pain, hematuria, abdominal mass and so on. computed tomography (CT) plays an important role in the diagnosis of rEWs, and the typical manifestation is a large heterogeneous soft tissue density mass, with a specific "septum-like" enhancement in contrast-enhanced scan. The 2-year overall survival rate of rEWs was 48%, with a median survival time of 18 months. "Septum-like" enhancement on CT can be used as a relatively specific sign for the differential diagnosis of rEWs from Wilms tumor and neuroblastoma. The maximum diameter of the rEWs was usually greater than 10 cm, the clinical symptoms of weight loss, metastasis at diagnosis, tumor thrombogenesis of renal vein or/and inferior vena cava tumor, and the failure to undergo radical nephrectomy were the factors of poor prognosis. The incidence of primary rEWs is low and the prognosis is poor. Early diagnosis and radical nephrectomy combined with chemotherapy is the key to improve the prognosis of patients, and CT plays an important role in early diagnosis.

Metastatic renal Ewing's sarcoma in adult woman: Case report and review of the literature

Primary renal extra-skeletal Ewing sarcoma is a rare neoplasm, often metastatic at diagnosis, and with a poor outcome. A multimodal approach is often the treatment of choice in this aggressive neoplasm. We present a case of primary renal extra-skeletal sarcoma in a 45-year-old woman who underwent tumor resection without clear margins. After no response to the first cycle of chemotherapy, we documented an early onset of local recurrence. The patient refused any other treatment and died four months after surgery.

Ewing's sarcoma/primitive neuroectodermal tumor of the kidney: a case report and literature review

Ewing sarcoma/primitive neuroectodermal tumor (ES/PNET) is a malignant bone, and soft-tissue tumor derived from neuroectoderm. It occurs in pediatric adolescents with the histopathological features of invasiveness. Renal involvement is extremely rare, which is limited to case reports and small case series. Most patients showed non-specific symptoms, such as abdominal pain and severe hematuria. The corresponding diagnosis was based on pathological features and immunohistochemical detection. So far, the characteristics of computed tomography (CT) have been rarely described in these cases. We report an 18-year-old man diagnosed with renal ES/PNET, who suffered from a sudden left flank pain associated with gross hematuria. The CT images showed an irregular soft tissue mass with a size of 7.3 cm × 7.0 cm × 9.0 cm. The patient underwent laparoscopic nephrectomy of the left kidney. The final diagnosis of renal ES/PNET was confirmed by immunohistochemical detection and fluorescence in situ hybridization of the nephrectomy specimen. We want to point out that CT scanning is still a useful method for preliminary assessment in preoperative diagnosis.