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Koka K, Rahim FE, El-Hadad C, Bell D, Debnam JM, Guo Y, Esmaeli B. Primary Ewing's sarcoma with orbit involvement: Survival and visual outcomes after eye-sparing multidisciplinary management in eight patients. Head Neck 2021; 43:3857-3865. [PMID: 34632670 DOI: 10.1002/hed.26884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/13/2021] [Accepted: 09/10/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To describe the clinical presentation, treatment, and overall prognosis in eight patients with primary Ewing's sarcoma (ES) involving the orbit. METHODS A retrospective interventional study of all biopsy-proven cases of primary ES involving the orbit was done. RESULTS There were seven males and one female with a median age of 14 years. Imaging showed osseous involvement in all eight cases with extraorbital extension in four. Complete tumor resection was done in four, partial resection in three, and biopsy followed by sinus surgery in one. EWSR1 gene rearrangement analysis was done to confirm diagnosis. All patients received multidrug systemic chemotherapy and seven patients received adjuvant radiotherapy. Eye salvage was achieved in all patients. At a mean follow-up duration of 52.63 months, seven patients were doing well with no evidence of disease. CONCLUSIONS ES involving the orbit is sensitive to chemotherapy and radiation. Aggressive multimodality treatment can help salvage the globe and improve overall survival.
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Affiliation(s)
- Kirthi Koka
- Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Farrah E Rahim
- Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Christian El-Hadad
- Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Diana Bell
- Department of Pathology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - J Matthew Debnam
- Department of Neuroradiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Yunxia Guo
- Department of Head and Neck Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
| | - Bita Esmaeli
- Oncology & Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA
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A review of nasal, paranasal, and skull base tumors invading the orbit. Surv Ophthalmol 2017; 63:389-405. [PMID: 28739401 DOI: 10.1016/j.survophthal.2017.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 07/16/2017] [Accepted: 07/17/2017] [Indexed: 11/20/2022]
Abstract
Tumors that invade the orbit are uncommon. The majority are meningiomas arising from the sphenoid ridge (66%). Others are bone and cartilage tumors arising from the surrounding bones of the orbit, pituitary adenomas, and epithelial tumors arising from the paranasal sinuses and nasal cavity. Meningiomas occur more often in women, whereas epithelial tumors have a predilection for men. Meningiomas and epithelial tumors typically present in the sixth decade of life, whereas bone tumors tend to affect individuals in their third decade of life. Patients often present with a combination of ophthalmological and otorhinolaryngological symptoms, including proptosis, pain, decreased visual acuity, restrictions in motility of the eye, epistaxis, and nasal obstruction. Sarcomas and benign bone and cartilage tumors arise from surrounding structures, whereas carcinomas usually arise from the paranasal sinuses. Surgery is the mainstay of treatment. Depending on the aggressiveness and histology of the tumor, surgery may be combined with radiation and chemotherapy. The prognosis is generally poor, but varies depending on histology and cell origin, size of the tumor, and degree of invasion. Meningiomas and benign bone tumors have the best prognoses. Sinonasal undifferentiated carcinomas, small-cell neuroendocrine carcinomas, osteosarcomas, and rhabdomyosarcomas have poorer prognoses.
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Abstract
In the span of the last 48 years, only 33 cases of children with orbital Ewing sarcoma have been reported. This study is to present 3 cases that were admitted to Children's Cancer Hospital Egypt 57357, during the period from 2009 to 2013. We have 2 cases treated using the hospital standard Ewing sarcoma treatment protocol, to completion, whereas the third discontinued treatment. All tumors have confirmed CD99 positivity, although translocation (11;22) was positive in 1 patient and negative in the third. With earlier diagnosis and adequate surgical resection and integration of chemotherapy and radiotherapy 1 patient survived for about 4 years, whereas the other 2 cases died due to disease progression or recurrence.
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4
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Li M, Hoschar AP, Budd GT, Chao ST, Scharpf J. Primary Ewing's sarcoma of the ethmoid sinus with intracranial and orbital extension: case report and literature review. Am J Otolaryngol 2013; 34:563-8. [PMID: 23706594 DOI: 10.1016/j.amjoto.2013.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 04/12/2013] [Indexed: 10/26/2022]
Abstract
The Ewing's sarcoma family of tumors is a group of cancers that commonly arises in young adults during their second decade of life. It frequently involves the trunk and long bones of the body with primary Ewing's sarcoma of the paranasal sinuses being exceedingly rare. We describe the case of a 39 year-old female with primary Ewing's Sarcoma originating from the ethmoid sinus with intracranial extension into the anterior cranial fossa and the orbit. The radiologic and histopathologic profiles are presented with a review of the literature. To our knowledge, this is the second reported case with the tumor involving the anterior cranial fossa, but the only case where immunochemical staining and molecular genetic analysis are available for definitive diagnosis.
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5
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Yang Y, Liu Y, Yin Z. Primary orbital Ewing sarcoma. J Pediatr Ophthalmol Strabismus 2011; 48 Online:e43-8. [PMID: 21766739 DOI: 10.3928/01913913-20110712-05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2011] [Accepted: 06/01/2011] [Indexed: 11/20/2022]
Abstract
The authors report the clinical manifestations, pathologic character, management, and prognosis of primary orbital Ewing sarcoma, and review pertinent literature. A 6-year-old boy presented with the complaint of abruptly decreasing visual acuity and right proptosis. Computed tomography scan revealed a mass in the region of the right infratemporal orbit with extension into the infratemporal fossa and masseteric space, and there was erosion of the right lateral orbital wall. An anterior orbitotomy eyelid crease was performed to remove the tumor. The tumor cells were positive in membranous pattern for CD99 immunostaining; all other reactions were negative. The EWS-FLI-1 fusion gene was not detected by reverse-transcription polymerase chain reaction. Combined radiotherapy was applied. Primary orbital Ewing sarcoma is an extremely rare malignant tumor that shows a predilection for males (ratio: 1.4 to 1). Appropriate treatment consists of local resection, radiotherapy, and adjunctive chemotherapy.
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Affiliation(s)
- Yuli Yang
- Southwest Hospital, Southwest Eye Hospital, Third Military Medical University, No. 30 Gaotanyan Main Street, Shapingba District, Chongqing 400038, China.
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6
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Solitary extra-skeletal sinonasal metastasis from a primary skeletal Ewing's sarcoma. The Journal of Laryngology & Otology 2011; 125:861-4. [PMID: 21729453 DOI: 10.1017/s0022215111000764] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Ewing's sarcoma is a rare, malignant tumour predominantly affecting young adolescent males. We describe a unique case of an isolated extra-skeletal metastasis from a skeletal Ewing's sarcoma primary, arising in the right sinonasal cavity of a young man who presented with severe epistaxis and periorbital cellulitis. RESULTS Histologically, the lesion comprised closely packed, slightly diffuse, atypical cells with round, hyperchromatic nuclei, scant cytoplasm and occasional mitotic figures, arranged in a sheet-like pattern. Immunohistochemical analysis showed positive staining only for cluster of differentiation 99 glycoprotein. Fluorescent in situ hybridisation identified the Ewing's sarcoma gene, confirming the diagnosis. MANAGEMENT Complete surgical resection was achieved via a minimally invasive endoscopic transnasal approach; post-operative radiotherapy. Ten months post-operatively, there were no endoscopic or radiological signs of disease. CONCLUSION Metastatic Ewing's sarcoma within the head and neck is incredibly rare and can pose significant diagnostic and therapeutic challenges. An awareness of different clinical presentations and distinct histopathological features is important to enable early diagnosis. This case illustrates one potential management strategy, and reinforces the evolving role of endoscopic transnasal approaches in managing sinonasal cavity and anterior skull base tumours.
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7
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Hafezi S, Seethala RR, Stelow EB, Mills SE, Leong IT, MacDuff E, Hunt JL, Perez-Ordoñez B, Weinreb I. Ewing's family of tumors of the sinonasal tract and maxillary bone. Head Neck Pathol 2010; 5:8-16. [PMID: 21107767 PMCID: PMC3037459 DOI: 10.1007/s12105-010-0227-x] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2010] [Accepted: 11/10/2010] [Indexed: 10/18/2022]
Abstract
The Ewing's family of tumors (EFT) are malignant neoplasms affecting children and young adults. Most cases arise in the long bones or the pelvis. Primary EFT of head and neck is uncommon and primary sinonasal EFT is even rarer. Previous studies have not focused on the sinonasal region specifically, and the published literature on sinonasal EFT consists of sporadic case reports. Fourteen cases of sinonasal EFT were available and had H&Es for review and immunohistochemical stains for CD99, S100, keratins, synaptophysin and desmin. FISH or RT-PCR was performed for EWSR1 abnormalities on 8 cases. The 14 identified patients included 5 males and 9 females, ranging from 7-70 years of age (mean 32.4 years). Tumors involved nasal cavity (5), sinuses (5) or both (4). Five patients had dural, orbital or brain involvement. The majority involved bone radiologically and/or microscopically. All cases were composed of small cells with variable cytoplasmic clearing. Focal or prominent nesting was noted in most cases. All cases were positive for CD99. Keratins (AE1/3 and/or CAM5.2), S100 and synaptophysin were positive in 4, 3 and 5 cases, respectively. All cases were negative for desmin. The 8 cases tested by FISH or RT-PCR were positive for EWSR1 abnormalities. Follow-up in 8 patients ranged from 1-168 months (average 11.3 m) showing 1 death due to metastatic disease, 1 death due to local disease, 1 patient alive with metastases and 5 patients disease-free at last follow-up. Interestingly, however, an analysis of the literature suggests a better prognosis for sinonasal EFT than EFT overall.
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Affiliation(s)
- Sara Hafezi
- Department of Pathology, University Health Network, Toronto, ON Canada ,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Raja R. Seethala
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA USA
| | - Edward B. Stelow
- Department of Pathology, University of Virginia, Charlottesville, VA USA
| | - Stacey E. Mills
- Department of Pathology, University of Virginia, Charlottesville, VA USA
| | - Iona T. Leong
- Departments of Pathology and Dentistry, Mount Sinai Hospital, Toronto, ON Canada
| | | | - Jennifer L. Hunt
- Department of Pathology, Massachusetts General Hospital, Boston, MA USA
| | - Bayardo Perez-Ordoñez
- Department of Pathology, University Health Network, Toronto, ON Canada ,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
| | - Ilan Weinreb
- Department of Pathology, University Health Network, Toronto, ON Canada ,Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON Canada
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8
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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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9
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Kasliwal MK, Agrawal D, Mahapatra AK. Magnetic resonance imaging of primary orbital Ewing's sarcoma. Pediatr Neurosurg 2005; 41:192-6. [PMID: 16088254 DOI: 10.1159/000086560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2004] [Accepted: 12/29/2004] [Indexed: 11/19/2022]
Abstract
The authors describe the MRI findings of a primary orbital Ewing's sarcoma in a 5-year-old boy, who underwent an extensive tumour surgery as these findings were mistaken for more chemoresistant sarcomas such as rhabdomyosarcoma. This case illustrates the fact that MR findings of primary orbital Ewing's sarcoma may be different from those of Ewing's sarcoma present elsewhere in the body. An accurate preoperative diagnosis may therefore result in a more conservative approach and prove extremely useful in such tumours.
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Affiliation(s)
- Manish K Kasliwal
- Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi, India
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10
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Sharma A, Garg A, Mishra NK, Gaikwad SB, Sharma MC, Gupta V, Suri A. Primary Ewing's sarcoma of the sphenoid bone with unusual imaging features: a case report. Clin Neurol Neurosurg 2004; 107:528-31. [PMID: 16202829 DOI: 10.1016/j.clineuro.2004.11.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2004] [Revised: 10/16/2004] [Accepted: 11/08/2004] [Indexed: 11/29/2022]
Abstract
Ewing's sarcomas (ES) account for approximately 10% of primary malignant bone tumors. Primary Ewing's sarcoma of the skull is a very rare entity. We report a case of Ewing's sarcoma of the sphenoid bone in a 5-year-old boy. CT scan showed heterogeneously enhancing mass with associated spiculated new bone formation along the posterolateral wall of the orbit. Magnetic resonance (MR) imaging showed markedly heterogeneously signal intensity mass lesion containing areas of hemorrhage and fluid-fluid levels. Spiculated new bone formation and fluid-fluid levels had not been reported previously in skull Ewing's sarcomas and may be helpful features for preoperative diagnosis.
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Affiliation(s)
- Ashwani Sharma
- Department of NeuroRadiology, Neurosciences Center, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India
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11
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Abstract
Primary tumors of orbital bone constitute 0.6% to 2% of all orbital tumors. Our experience over a 24-year period in the Orbital Clinic at the University of British Columbia yielded 62 (1.9%) cases from a total of 3,340 orbital tumors. Although a heterogeneous group, primary orbital bone tumors may be classified on a clinicopathologic basis into benign fibro-osseous or cartilaginous, reactive, neoplastic and vascular disorders. Presentation is usually a gradual mass effect, with infiltration and acute hemorrhage being features of malignant and reactive lesions respectively. The two most commonly encountered entities were fibrous dysplasia and osteoma, accounting for 22 cases. Although both these conditions rarely present a diagnostic challenge, nonspecific histologic and radiologic appearances can result in poor characterization of several of the rarer lesions. Hence, close cooperation between clinician, radiologist and pathologist is essential for accurate diagnosis.
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Affiliation(s)
- Dinesh Selva
- Department of Ophthalmology, University of Adelaide and the Royal Adelaide Hospital, Adelaide, Australia
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12
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Bajaj MS, Pushker N, Sen S, Chandra M, Ghose S, Shekar CN. Primary Ewing's sarcoma of the orbit: a rare presentation. J Pediatr Ophthalmol Strabismus 2003; 40:101-4. [PMID: 12691234 DOI: 10.3928/0191-3913-20030301-11] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Mandeep S Bajaj
- Oculoplastic and Pediatric Ophthalmology Services, Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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13
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Abstract
PURPOSE To report the clinicopathologic features of a 17-year-old patient with primary Ewing sarcoma of the orbit. METHODS The patient was evaluated clinically before surgery with computed tomography scans of the orbit. After surgery, the patient was staged with computed tomography scans and bone scan and was treated with systemic chemotherapy and radiation therapy to the orbit. The orbital biopsy was evaluated with conventional light microscopy and immunohistochemistry. RESULTS Clinical evaluation revealed proptosis and limited upgaze. Computed tomography scans disclosed a mass involving the superior orbit, anterior cranial fossa, and temporal fossa. Microscopic examination revealed small, poorly differentiated cells with medium-sized nuclei containing finely granular chromatin and small nucleoli. The cytoplasmic borders of the cells were indistinct. A PAS stain revealed modest glycogen in many of the tumor cells. The tumor stained positive for O-13 and vimentin and was negative for neural, skeletal, and lymphoid cell markers. Computed tomography scan, bone scan, and blood chemistries revealed no other site of involvement. After treatment, the clinical symptoms and signs resolved, and there has been no evidence of residual orbital tumor or metastasis. CONCLUSIONS Primary Ewing sarcoma of the orbit should be considered in the differential diagnosis of children or young adults with proptosis, diplopia, or periorbital swelling. Immunohistochemistry is essential to distinguish Ewing sarcoma from other small round cell tumors.
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Affiliation(s)
- D J Wilson
- Casey Eye Institute, Oregon Health Sciences University, Portland 97201, USA
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14
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Erol FS, Ozveren MF, Ozercan IH, Topsakal C, Akdemir I. Primary Ewing's sarcoma of the occipital bone--case report. Neurol Med Chir (Tokyo) 2001; 41:206-9. [PMID: 11381680 DOI: 10.2176/nmc.41.206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A 17-year-old female presented with a very rare case of primary Ewing's sarcoma of the skull involving the occipitotemporal region. Systemic examination found no evidence of metastasis. The tumor was surgically removed, and the patient underwent radiotherapy and chemotherapy. Fourteen months after surgery there has been no recurrence of the tumor. Cranial primary Ewing's tumor has a good prognosis after radical surgery and adjuvant therapy.
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Affiliation(s)
- F S Erol
- Department of Neurosurgery, School of Medicine, University of Firat, Elazig, Turkey
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15
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Abstract
PURPOSE Ewing's tumor is a primary tumor of bone in childhood that only rarely involves the orbit. Most such cases are metastatic from distant sites. This tumor may be confused with other small round cell malignancies of childhood, and immunohistochemical studies are essential in making the diagnosis. METHODS We present two cases of Ewing's tumor of the orbit. One was in a 22-year-old boy with an occult primary tumor in the frontal bone that became symptomatic after forehead trauma. The other example was in a 7-year-old boy with a known Ewing's primary of the clavicle. The clinical manifestations and diagnostic criteria are discussed. RESULTS In most cases with orbital involvement, ophthalmic symptoms consist of proptosis, pain, and occasionally visual loss and motility restriction. The diagnosis is typically unsuspected before histologic evaluation. Electron microscopic and immunohistochemical analyses are essential in making the diagnosis and are necessary for all such small round cell tumors. CONCLUSIONS Ewing's sarcoma is a rare orbital tumor of bone mainly affecting children. Local treatment relying on surgical extirpation and radiotherapy alone has proven inadequate, with 5-year survival rates of <10%. The addition of chemotherapy has improved survival rates significantly to approximately 50%.
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Affiliation(s)
- J J Dutton
- The Department of Ophthalmology, Duke University Eye Center, Durham, North Carolina, USA
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16
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Hadfield MG, Quezado MM, Williams RL, Luo VY. Ewing's family of tumors involving structures related to the central nervous system: a review. Pediatr Dev Pathol 2000; 3:203-10. [PMID: 10742406 DOI: 10.1007/s100249910026] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This review consolidates information gleaned from several case reports and larger series on Ewing's sarcoma family of tumors (EFT) involving structures related to and found in the central nervous system (CNS). These tumors involve the skull, the spinal column, adjacent soft tissues, the meninges, and the brain. We have separated the cases by skull region and spinal column level, and we discuss the attendant differences in prognosis following treatment by neurosurgery, radiation, and chemotherapy. Light and electron microscopic features can be used to differentiate EFT from other small round blue cell tumors that involve the CNS (central primitive neuroectodermal tumor, lymphoma, etc.). Recent molecular and genetic findings in EFT provide new diagnostic methods. We conclude that EFT involving the CNS and adjacent structures is not so rare as previously stated and that the prognosis is more favorable, as a rule, than for the more common examples arising in the long bones and pelvis.
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Affiliation(s)
- M G Hadfield
- Division of Neuropathology, Medical College of Virginia Campus/Virginia Commonwealth University, Richmond, VA 23298, USA
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17
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Desai KI, Nadkarni TD, Goel A, Muzumdar DP, Naresh KN, Nair CN. Primary Ewing's Sarcoma of the Cranium. Neurosurgery 2000. [DOI: 10.1093/neurosurgery/46.1.62] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Ketan I. Desai
- Department of Neurosurgery King Edward Memorial Hospital, Seth G.S. Medical College
| | - Trimurti D. Nadkarni
- Department of Neurosurgery King Edward Memorial Hospital, Seth G.S. Medical College
| | - Atul Goel
- Department of Neurosurgery King Edward Memorial Hospital, Seth G.S. Medical College
| | | | | | - Chandrika N. Nair
- Department of Medical Oncology Tata Memorial Hospital, Parel, Mumbai, India
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18
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Lam DS, Li CK, Cheng LL, Teo JG, Chik KW, Kwan WH, Ng JS, Poon WW, Yuen PM. Primary orbital Ewing's sarcoma: report of a case and review of the literature. Eye (Lond) 1999; 13 ( Pt 1):38-42. [PMID: 10396382 DOI: 10.1038/eye.1999.8] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Primary orbital Ewing's sarcoma is a very rare condition. Since the first case was reported in 1950, only 7 other cases have been reported in the English literature. Herein we describe the ninth, the only bilateral and the youngest case of primary orbital Ewing's sarcoma occurring in a 2-year-old boy, who presented to us with bilateral painless proptosis. Tissue biopsy of the tumour was obtained through the nasal sinus. Immunohistological studies of the biopsy tissue confirmed the diagnosis of Ewing's sarcoma. No distant site of the tumour was found so this was considered a primary orbital tumour. Combined chemotherapy and radiotherapy without surgical resection achieved an encouraging result in that the patient has remained in remission for 30 months after completion of treatment. The successful use of combined chemotherapy and radiotherapy, without surgery, adds further support to evidence that surgical excision may be avoided in selected cases of primary orbital Ewing's sarcoma.
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Affiliation(s)
- D S Lam
- Department of Ophthalmology and Visual Sciences, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T.
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19
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Vidyasagar MS, Rao S, Fernandes DJ, Ramanujam AS. A rare case of primary Ewings sarcoma of the nasal bone. Indian J Otolaryngol Head Neck Surg 1998; 50:69-72. [PMID: 23119384 PMCID: PMC3451260 DOI: 10.1007/bf02996777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Primary Ewing's sarcoma of the nasal bone has not been previously described. This case presented as a mass in the left ala of the nose in a five year old female child. The clinical, radiological, microscopic features are described and a review of literature is presented. The case was treated with neoadjuvant chemotherapy and local electron beam radiation therapy. The child was free of disease when she reported for follow up in July 1997. Although wide excision is part of the treatment approach in Ewing's sarcoma, in sites where surgery is not suitable local radiotherapy and chemotherapy adequately controls primary disease.
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Affiliation(s)
- M S Vidyasagar
- Dept. of Radiotherapy and Oncology, Kasturba Medical College & Hospital, Manipal, 576119 Karnataka, India
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20
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Watanabe H, Tsubokawa T, Katayama Y, Koyama S, Nakamura S. Primary Ewing's sarcoma of the temporal bone. SURGICAL NEUROLOGY 1992; 37:54-8. [PMID: 1727085 DOI: 10.1016/0090-3019(92)90067-w] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Primary cranial Ewing's sarcoma is exceptionally rare. Only ten cases of such a tumor had been reported heretofore in the literature. We describe a case of primary Ewing's sarcoma occurring in the temporal bone. The tumor was surgically excised, and the patient underwent radiation and chemotherapy. Neither recurrence nor distant metastasis was noted at 12 months after surgery. Although the prognosis of Ewing's sarcoma in general is often poor because of early metastasis to the lungs and/or to other bones, a review of the literature suggested that the same tumor occurring in the cranium can often be successfully managed by intensive therapy with radical excision and radiochemotherapy. This inference was supported by the case reported here.
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Affiliation(s)
- H Watanabe
- Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
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21
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Mamede RM, Mello FV, Barbieri J. Prognosis of Ewing's sarcoma of the head and neck. Otolaryngol Head Neck Surg 1990; 102:650-3. [PMID: 2115649 DOI: 10.1177/019459989010200604] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Five children with Ewing's sarcoma, an uncommon neoplasm originating in the facial bones, were treated with chemotherapy, surgery, and radiotherapy. Younger children have poor prognoses. Children with tumors originating in the mandible appear to have better prognoses. Hematogenic metastases were the most frequent and those originating from maxillary tumors showed much faster growth and were resistant to the chemotherapy used.
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Affiliation(s)
- R M Mamede
- Department of Head and Neck Surgery, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
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Woodruff G, Thorner P, Skarf B. Primary Ewing's sarcoma of the orbit presenting with visual loss. Br J Ophthalmol 1988; 72:786-92. [PMID: 3191083 PMCID: PMC1041584 DOI: 10.1136/bjo.72.10.786] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A case of primary Ewing's sarcoma of the orbit and paranasal sinuses in a 6-yearold boy is reported. The child presented with headaches and unilateral visual loss. Loss of vision as a result of optic nerve involvement with primary Ewing's sarcoma is extremely rare.
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Affiliation(s)
- G Woodruff
- Department of Ophthalmology, Hospital for Sick Children, Toronto, Ontario, Canada
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