1
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Borrelli M, Shamsian A, Hopp ML, Schenck NL. Ewing Sarcoma of the Ethmoid Sinus in an Adult. EAR, NOSE & THROAT JOURNAL 2024; 103:NP328-NP330. [PMID: 34779260 DOI: 10.1177/01455613211053426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Extraskeletal Ewing sarcoma (EES) is a relatively rare primary tumor of the soft tissues predominantly affecting men in the second and third decades of life. They are a less common form of the cancerous growth known as an Ewing sarcoma, which occurs in bones or soft tissue such as cartilage. Head and neck ESS can require intervention including endoscopic sinus surgery, septoplasty, inferior turbinectomy, and left internal nasal valve repairs with septal cartilage This is a case report on an unusual presentation of ESS in the sinonasal region.
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Affiliation(s)
- Michela Borrelli
- Cedars-Sinai Sinus Center, Los Angeles, CA, USA
- Cedars-Sinai Division of Otolaryngology, Los Angeles, CA, USA
| | - Arash Shamsian
- Cedars-Sinai Sinus Center, Los Angeles, CA, USA
- Cedars-Sinai Division of Otolaryngology, Los Angeles, CA, USA
| | - Martin L Hopp
- Cedars-Sinai Sinus Center, Los Angeles, CA, USA
- Cedars-Sinai Division of Otolaryngology, Los Angeles, CA, USA
| | - Nicholas L Schenck
- Cedars-Sinai Sinus Center, Los Angeles, CA, USA
- Cedars-Sinai Division of Otolaryngology, Los Angeles, CA, USA
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2
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Ganguly A, Abbagoni V, Narmala S. Ewing Sarcoma of the Vagina: A Rare Clinical Entity. Cureus 2024; 16:e56550. [PMID: 38646356 PMCID: PMC11027947 DOI: 10.7759/cureus.56550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/23/2024] Open
Abstract
Ewing sarcoma (EwS), a malignancy primarily affecting adolescents and young adults, encompasses various types such as bone, extraskeletal, chest wall, and soft tissue-based tumors, all of which share a common genetic origin. A small portion of them are extraosseous, impacting diverse anatomical sites. Characterized by a specific translocation, this rare cancer rarely involves the vagina, with very few documented cases. This report details the unique case of a middle-aged woman diagnosed with extraosseous vaginal EwS, a rarity in this age group and gender. With no established guidelines, a multidisciplinary approach is crucial, emphasizing the need for further case reporting to enhance understanding and management strategies.
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Affiliation(s)
- Arup Ganguly
- Internal Medicine, University of Connecticut School of Medicine, Farmington, USA
| | | | - Shravan Narmala
- Hematology and Oncology, Doctors Hospital at Renaissance Health, Edinburg, USA
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3
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Jia F, Liu L, Weng Q, Zhang H, Zhao X. Glycolysis-Metabolism-Related Prognostic Signature for Ewing Sarcoma Patients. Mol Biotechnol 2023:10.1007/s12033-023-00899-5. [PMID: 37775679 DOI: 10.1007/s12033-023-00899-5] [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: 07/07/2023] [Accepted: 09/11/2023] [Indexed: 10/01/2023]
Abstract
Ewing sarcoma (EwS) is a malignant sarcoma which occurs in bone and soft tissues commonly happening in children with poor survival rates. Changes in cell metabolism, such as glycolysis, may provide the environment for the transformation and progression of tumors. We aimed to build a model to predict prognosis of EwS patients based on glycolysis and metabolism genes. Candidate genes were obtained by differential gene expression analysis based on GSE17679, GSE17674 and ICGC datasets. We performed GO and KEGG pathway enrichment analysis on candidate genes. Univariate Cox and LASSO Cox regression analyses were conducted to construct a model to calculate the Risk Score. GSEA was done between high-risk and low-risk groups. CIBERSORT was applied to analyze the immune landscape. We got 295 candidate glycolysis-metabolism-related genes which were enriched in 620 GO terms and 18 KEGG pathways. 12 Genes were selected by univariate Cox model and 5 of them were determined by LASSO Cox regression analysis to be used in the construction of the Risk Score model. The Risk Score could be considered as an independent prognosis factor. The immune landscape and immune checkpoints' expression significantly differed between high- and low-risk groups. Our research constructed a new glycolysis-metabolism-related genes (FABP5, EMILIN1, GLCE, PHF11 and PALM3) based prognostic signature for EwS patients and assisted in gaining insight into prognosis to improve therapies further.
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Affiliation(s)
- Fusen Jia
- Department of Hand & Foot Surgery, Zibo Central Hospital, Zhangdian District, Zibo, 255036, Shandong, People's Republic of China
| | - Lei Liu
- Orthopedic Surgery 2nd, Qilu Hospital Huantai Branch, Huantai County, Zibo, 256400, Shandong, People's Republic of China
| | - Qi Weng
- Department of Psychology, Zibo Maternal and Child Health Hospital, Zhangdian District, Zibo, 255022, Shandong, People's Republic of China
| | - Haiyang Zhang
- Department of Hand & Foot Surgery, Zibo Central Hospital, Zhangdian District, Zibo, 255036, Shandong, People's Republic of China
| | - Xuesheng Zhao
- Orthopedic Surgery 2nd, The Fifth People's Hospital of Jinan, No. 24297 Jingshi Road, Huaiyin District, Jinan, 250000, Shandong, People's Republic of China.
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4
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Worthy J, Ganguli MP, Kile MR, Satei AM, Mills ND. A Rare Case of Sinonasal Ewing Sarcoma With Radiologic-Pathologic Correlation. Cureus 2023; 15:e43708. [PMID: 37724222 PMCID: PMC10505484 DOI: 10.7759/cureus.43708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2023] [Indexed: 09/20/2023] Open
Abstract
An 89-year-old male presented with syncope and worsening difficulty in breathing through the left nostril. Computed tomography demonstrated a tumor in the anterior ethmoid air cells and maxillary sinus, which extended into the frontal lobe. Magnetic resonance imaging similarly demonstrated an aggressive lesion. This mass was difficult to differentiate from more commonly seen lesions at this location such as an esthesioneuroblastoma or nasopharyngeal carcinoma. Direct visualization, biopsy, and subsequent pathologic analysis eventually confirmed the diagnosis of malignant Ewing sarcoma (EWS). Our case explores the radiological findings of EWS originating from the ethmoid sinus, compares EWS with other common carcinomas in the same location, confirms the diagnosis through pathological correlation, and investigates the prognosis and treatment of these lesions. This case highlights the importance of a multidisciplinary approach to diagnose EWS when it occurs in an atypical location. The clinical team relied on input from the radiology, surgery, ENT, neurology, and pathology departments to make an accurate diagnosis and plan treatment for this aggressive tumor.
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Affiliation(s)
- Jennifer Worthy
- Medicine, Ross University School of Medicine, Bridgetown, BRB
| | | | - Mahlon R Kile
- Medicine, Ross University School of Medicine, Bridgetown, BRB
| | - Alexander M Satei
- Diagnostic Radiology, Trinity Health Oakland Hospital, Pontiac, USA
- Diagnostic Radiology, Wayne State University School of Medicine, Detroit, USA
| | - Nicholas D Mills
- Diagnostic Radiology, Trinity Health Oakland Hospital, Pontiac, USA
- Diagnostic Radiology, Wayne State University School of Medicine, Detroit, USA
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5
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Asadbeigi SN, Diaz-Perez JA, Rosenberg AE, Pettus JR, Kerr DA, Linos K. Highlighting the Diversity of Desmoplastic Small Round Cell Tumor: A Case Series. Int J Surg Pathol 2023; 31:142-151. [PMID: 35466756 DOI: 10.1177/10668969221095178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Desmoplastic small round cell tumor (DSRCT) is a rare malignant tumor that occurs mainly in the retroperitoneum of children and young adults. In its prototypical form, DSCRT displays characteristic morphology with nested primitive small round cells in a desmoplastic stroma and a distinctive immunophenotype with polyphenotypic differentiation. However, DSCRT can also exhibit a broader clinical, histologic and immunohistochemical spectrum and, therefore, cause diagnostic difficulties. Given that DSCRT is an aggressive and nearly universally fatal disease, making the correct diagnosis is critically important. Herein, we report three patients with DSRCT and unusual clinical, morphologic or immunohistochemical characteristics, in order to highlight its remarkable diversity and increase awareness of this unusual, distinctive neoplasm.
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Affiliation(s)
- Sepideh Nikki Asadbeigi
- Department of Dermatology, 12244McGaw Medical Center of Northwestern University, Chicago, IL, USA
| | - Julio A Diaz-Perez
- Department of Pathology, 12235University of Miami Miller School of Medicine, Miami, FL, USA
| | - Andrew E Rosenberg
- Department of Pathology, 12235University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jason R Pettus
- Department of Pathology and Laboratory Medicine, 22916Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,12285Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Darcy A Kerr
- Department of Pathology and Laboratory Medicine, 22916Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,12285Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Konstantinos Linos
- Department of Pathology and Laboratory Medicine, 22916Dartmouth Hitchcock Medical Center, Lebanon, NH, USA.,12285Geisel School of Medicine at Dartmouth, Hanover, NH, USA
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6
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Zacharia B. Tumors of the Posterior Elements of the Spine in Children—an Overview. Indian J Surg Oncol 2023. [DOI: 10.1007/s13193-023-01729-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023] Open
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7
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Periosteal Ewing Sarcoma: Imaging Features and Clinical Outcomes in 7 Patients. J Comput Assist Tomogr 2023; 47:78-85. [PMID: 36668980 DOI: 10.1097/rct.0000000000001382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of this study was to describe imaging features, treatment, and prognosis of patients with periosteal Ewing sarcoma (PES). MATERIALS AND METHODS Seven patients with PES treated between 2001 and 2020 were studied retrospectively for presenting symptoms, imaging features, treatment, and prognosis. RESULTS Among the 7 patients (mean age, 27.3 years) with local pain and/or mass of less than 6 months duration, 4 were males and 3 females (1.3:1). These surface tumors involved 3 long bones and 4 pelvic bones. Radiographs showed cortical erosions with 2 and CT with 4 long bone tumors. All 7 surface tumors showed normal marrow on MRI, and 4 tumors demonstrated normal marrow activity on 18FFDG fluorodeoxyglucose PET-CT. The only exception was a PES involving iliac bone with thin cortex and marrow extension, which demonstrated hypermetabolic marrow activity. All patients were treated initially with chemotherapy and optional radiation treatment with complete tumor resolution of a tibial PES in 1 patient. The remaining 2 patients with long bone PES had tumor resection and limb-salvage surgery and the 4 patients with pelvic bone PES had hemipelvectomy after chemotherapy/radiation treatment. Five patients were disease-free with long-term survival. A patient with a long bone PES and solitary lung metastasis at onset had tumor resection and metastasectomy with complete recovery without tumor recurrence. The 2 patients with pubic bone PES had complete recovery without tumor recurrence; however, the remaining 2 patients with iliac bone PES developed distant metastases and died within 2 years of diagnosis. CONCLUSIONS Periosteal Ewing sarcoma arises in periosteum of bone and spares medullary cavity. As compared with its intramedullary counterpart, the tumor has better prognosis with long-term survival. Rarely, the surface tumor arising at a bone with thin cortex, such as iliac bone or scapula, may have medullary involvement. We have described our experience in diagnosis and clinical management in 7 patients of this rare surface variant of the more common intramedullary Ewing sarcoma.
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Sharma A, Kuppurajan N, Anandan M, Madhavan D, P. B BK. Primitive neuroectodermal tumor of the kidney: an experience of three cases. AFRICAN JOURNAL OF UROLOGY 2022. [DOI: 10.1186/s12301-022-00304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Primitive neuroectodermal tumors (PNET) are highly aggressive tumors belonging to the Ewing’s sarcoma family. Primitive neuroectodermal tumor is a group of bone and soft tissue tumor arising from neuroectodermal tissues. They are characterized by the expression of MIC2 and neural markers like neuron-specific enolase, synaptophysin, S-100, vimentin, Leu-7, and the presence of the EWS-FLI1 translocation. It is a rare malignancy with only about 150 cases being published worldwide. The tumor usually presents with non-specific symptoms such as abdomen pain and hematuria. Inferior vena cava (IVC) involvement by renal PNET is extremely rare with only a handful cases reported in the literature and is a clinically challenging scenario. There is a dearth of data on the management of this disease; further, the management of this disease in current scenarios is not well reported. We report our experience with three cases over 11 years which spans all three spectrums of the disease: localized, locally advance and metastasis.
Case presentation
Case 1: 37-year-old gentleman presenting with hematuria found to have right renal tumor with IVC invasion which was found to be unresectable intraoperatively. Patient was started on chemotherapy but deteriorated and died 3 months later. Case 2: 38-year-old gentleman presenting with abdominal pain found to have locally advanced left renal tumor. Patient developed local recurrence and metastasis 15 months after resection but had stable disease for nearly 4 years before developing acute myeloid leukemia and withdrawing consent for treatment. Case 3: 13-year-old girl who presented with right abdominal mass and subsequently found to have localized disease. After aggressive chemotherapy, patient is now recurrence-free after nearly 11 years.
Conclusions
Our study aims to show the spectrum of renal primitive neuroectodermal tumors with outcomes in all three clinical scenarios, with the aim of reinforcing that high index of suspicion for this disease is required in young patients presenting with aggressive disease, and immunohistochemistry should be used when in doubt, as outcomes are greatly improved with adjuvant chemotherapy.
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Jalan D, Sreenivasan R, Prasad R, Singh DK, Jha AK. Ewing's Sarcoma of the Talus in an Adolescent Female: An Unusual Case Presentation With Review of Literature. Cureus 2022; 14:e30946. [DOI: 10.7759/cureus.30946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 11/07/2022] Open
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10
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He X, Song S, Yang P, Cao F, Li W, Liang P. A rare radiotherapy-sensitive primitive neuroectodermal tumor with APC gene amplification in an adult: a case report and literature review. J Int Med Res 2022; 50:3000605221118704. [PMID: 35983861 PMCID: PMC9393680 DOI: 10.1177/03000605221118704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Primitive neuroectodermal tumor (PNET) of the lung is rare in adults, and
treatment options vary. We herein describe the disease course and follow-up of
PNET in an adult. A 27-year-old man was admitted to our hospital because of
cough and headache, and whole-exome sequencing revealed positive expression of
the EWSR1-FLI1 fusion gene and amplification of the
APC gene. Although the patient received multidisciplinary
treatment including chemotherapy regimens of etoposide plus cisplatin; focal
radiotherapy focusing on the cerebrum, lung, and kidneys; and a subsequent
palliative gastrointestinal operation, he eventually died of multiple organ
functional failure. His overall survival period was 18 months, and his
progression-free survival period was 4 months. During the treatment, the patient
showed remarkable sensitivity to radiotherapy. In conclusion, PNET of the lung
in adult patients is extremely rare, and the prognosis is very poor. Involvement
of a multidisciplinary team in the development of personalized therapeutic
strategies is essential. This patient with APC gene
amplification showed excellent sensitivity to radiotherapy for intrapulmonary
and intracranial lesions, suggesting that APC gene
amplification may be related to radiotherapy sensitivity. However, further
clinical research is needed.
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Affiliation(s)
- Xin He
- Department of Respiratory Medicine, the Fourth Hospital of Hebei Medical University
| | - Shan Song
- Department of Medical Oncology, the Fourth Hospital of Hebei Medical University
| | - Peidan Yang
- Department of Pharmacy, the Fourth Hospital of Hebei Medical University
| | - Feng Cao
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University
| | - Weijing Li
- Department of Medical Records, the Fourth Hospital of Hebei Medical University
| | - Ping Liang
- Department of Pharmacy, the Fourth Hospital of Hebei Medical University
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Purushothaman P, Thambi SM, Abraham MM, Nair P S. Ewing's Sarcoma of the Gastrointestinal Tract—A Case Series. ASIAN JOURNAL OF ONCOLOGY 2022. [DOI: 10.1055/s-0042-1751114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AbstractEwing's sarcoma is a neoplasm of the undifferentiated small round cells, which generally affects the bone and deep soft tissues of children and adolescents. Extraskeletal Ewing's sarcomas are less common than skeletal Ewing's sarcoma with the most common sites being chest wall, retroperitoneal space, lower extremities, paravertebral region, and gluteal region. Primary Ewing's sarcoma of the gastrointestinal tract is rare. The rarity of cases, lack of specific literature, or guidelines for treatment and varying presentations make these cases challenging to diagnose and to treat. In this series, we share our experience from a tertiary cancer care center in South India. By our knowledge, this is the first case series in literature sharing the experience from a single center in treating four cases of gastrointestinal Ewing's sarcoma.
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Affiliation(s)
| | - Sugeeth M Thambi
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Mintu Mathew Abraham
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
| | - Sindhu Nair P
- Department of Medical Oncology, Regional Cancer Centre, Trivandrum, Kerala, India
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12
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Badheeb AM, Alshukami AA, Bashanfer GA, Alkhanbashi OM, Badheeb MA. Ewing's Sarcoma (Primitive Neuroectodermal Tumor) of Seminal Vesicles: A Case Report. Cureus 2022; 14:e21993. [PMID: 35282532 PMCID: PMC8906772 DOI: 10.7759/cureus.21993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2022] [Indexed: 11/05/2022] Open
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COL3A1 and Its Related Molecules as Potential Biomarkers in the Development of Human Ewing’s Sarcoma. BIOMED RESEARCH INTERNATIONAL 2021; 2021:7453500. [PMID: 35047627 PMCID: PMC8763479 DOI: 10.1155/2021/7453500] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/20/2021] [Indexed: 12/31/2022]
Abstract
Background Ewing's sarcoma (ES) is the most common malignant primary bone tumor in children and adolescents. This study is aimed at developing new prognostic markers and building a microRNA-mRNA network in the development of ES. Method GSE80201 and GSE39262 were downloaded from the Gene Expression Omnibus (GEO) database. Bioinformatics analysis was used to download and process data. The coexpression of differentially expressed microRNAs (DEMs) and genes (DEGs) was selected by using R software. The FunRich database was utilized to perform cellular component (CC), molecular function (MF), and biological process (BP) enrichment analysis. Cytoscape and ClueGO were used to perform Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis and construct the mRNA-microRNA network. The Kaplan-Meier Plotter was used to perform prognosis analysis between the expression level of genes we selected and overall survival (OS) of patients with ES. Univariate analysis and multivariate analysis were carried out to research the prognostic value of identified mRNA expression in ES according to TCGA database. Results By using bioinformatics analysis, 10 DEMs and 5 target mRNAs were identified. Based on the KmPlot software, COL1A2, COL3A1, and TGFBI were significantly related to the OS of patients with ES. High COL3A1 mRNA expression was correlated with distant metastasis, margin status, and poor overall survival of ES. Besides, multivariate analysis indicated that COL3A1 was an independent risk factor for ES patients. Conclusions In conclusion, our results suggest that COL3A1 and its related molecules may be a potential diagnostic and prognostic biomarker for patients with ES.
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Hussain A, Khurana AK, Goyal A, Joshi D. Askin's Tumour: Massive tumour with minimal symptoms. Sultan Qaboos Univ Med J 2021; 21:664-665. [PMID: 34888093 PMCID: PMC8631210 DOI: 10.18295/squmj.4.2021.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/07/2020] [Accepted: 01/24/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
| | | | | | - Deepti Joshi
- Pathology, All India Institute of Medical Sciences, Bhopal, India
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15
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Azizoglu M, Demirsoy U, Kulac I, Aktas S, Çorapcioglu F. EWSR1(22q12) Translocation Positive Pediatric Adrenal Tumor with Loss of 1p, 11q, and Unbalanced Gain of 17q: Neuroblastoma or Ewing Sarcoma? Fetal Pediatr Pathol 2021; 40:717-722. [PMID: 32242756 DOI: 10.1080/15513815.2020.1745971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Background Although neuroblastoma and Ewing sarcoma/Primitive neuroectodermal tumor are different clinical entities, they are both a member of small round blue cell tumors and can mimic each other's behavior in clinical and molecular aspects. Case report: A 3 year-old girl with an abdominal mass was found to have a small round blue cell tumor originating from the right adrenal gland. High level of neuron specific enolase, initial genetic test results (N-Myc amplification: negative, loss of 1p, 11q, and unbalanced gain of 17q) and characteristic radiological appearance of the tumor suggested a preliminary diagnosis of neuroblastoma but further analysis showed CD99 expression and presence of EWSR1 rearrangement, which are mostly observed in Ewing sarcoma. Conclusion: Adrenal gland tumors of childhood with complex immunophenotypic features requires distinguishing two discrete tumors in the small round blue cell tumor group, neuroblastoma and Ewing sarcoma. Although no exact diagnosis of the tumor was made, we reached a good response with neuroblastoma treatment protocol.
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Affiliation(s)
- Mehmet Azizoglu
- Department of Pediatric Oncology, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ugur Demirsoy
- Department of Pediatric Oncology, School of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Ibrahim Kulac
- Department of Pathology, School of Medicine, Koç University, Istanbul, Turkey
| | - Safiye Aktas
- Department of Basic Oncology, School of Medicine, Dokuz Eylül University, Izmir, Turkey
| | - Funda Çorapcioglu
- Department of Pediatric Oncology, School of Medicine, Kocaeli University, Kocaeli, Turkey
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16
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Morales E, Olson M, Iglesias F, Dahiya S, Luetkens T, Atanackovic D. Role of immunotherapy in Ewing sarcoma. J Immunother Cancer 2021; 8:jitc-2020-000653. [PMID: 33293354 PMCID: PMC7725096 DOI: 10.1136/jitc-2020-000653] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/09/2020] [Indexed: 12/11/2022] Open
Abstract
Ewing sarcoma (ES) is thought to arise from mesenchymal stem cells and is the second most common bone sarcoma in pediatric patients and young adults. Given the dismal overall outcomes and very intensive therapies used, there is an urgent need to explore and develop alternative treatment modalities including immunotherapies. In this article, we provide an overview of ES biology, features of ES tumor microenvironment (TME) and review various tumor-associated antigens that can be targeted with immune-based approaches including cancer vaccines, monoclonal antibodies, T cell receptor-transduced T cells, and chimeric antigen receptor T cells. We highlight key reasons for the limited efficacy of various immunotherapeutic approaches for the treatment of ES to date. These factors include absence of human leukocyte antigen class I molecules from the tumor tissue, lack of an ideal surface antigen, and immunosuppressive TME due to the presence of myeloid-derived suppressor cells, F2 fibrocytes, and M2-like macrophages. Lastly, we offer insights into strategies for novel therapeutics development in ES. These strategies include the development of gene-modified T cell receptor T cells against cancer–testis antigen such as XAGE-1, surface target discovery through detailed profiling of ES surface proteome, and combinatorial approaches. In summary, we provide state-of-the-art science in ES tumor immunology and immunotherapy, with rationale and recommendations for future therapeutics development.
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Affiliation(s)
- Erin Morales
- Pediatric Oncology and Hematology, University of Utah, Salt Lake City, Utah, USA
| | - Michael Olson
- Cancer Immunotherapy, Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Fiorella Iglesias
- Pediatric Oncology and Hematology, University of Utah, Salt Lake City, Utah, USA
| | - Saurabh Dahiya
- Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Tim Luetkens
- Pediatric Oncology and Hematology, University of Utah, Salt Lake City, Utah, USA.,Cancer Immunotherapy, Huntsman Cancer Institute, Salt Lake City, Utah, USA.,Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA.,Hematology and Hematologic Malignancies, University of Utah/Huntsman Cancer Institute, Salt Lake City, Utah, USA
| | - Djordje Atanackovic
- Cancer Immunotherapy, Huntsman Cancer Institute, Salt Lake City, Utah, USA .,Department of Medicine, University of Maryland School of Medicine and Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA.,Hematology and Hematologic Malignancies, University of Utah/Huntsman Cancer Institute, Salt Lake City, Utah, USA
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Morsy AM, Abdel-Hadi S, Rezk KM, Amira G, Ahmed BM, Hussien MT, Ameen MG, Kamel HEM, Fouad DM, Attia AM, Salah A, Abd Elbadee OM, Yousseif AA, Abdelgawad MI, Fathy AH, Elwany YN, Ramadan IKA, Mosallam KH, Abd Elwahab AI, Mahmoud KH, Amine MAF, Abd Elzaher AR, Eltyb HA, Hefni AM. Ewing sarcoma outcomes in a country with limited resources: Egypt as an example. Am J Cancer Res 2021; 11:3212-3226. [PMID: 34249456 PMCID: PMC8263650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/15/2021] [Indexed: 06/13/2023] Open
Abstract
As the scarcity of published research that comprehensively and meticulously analyzed the patient, disease, and treatment factors of prognostic significance in Ewing sarcoma (EWS) in Egypt; This study aimed at assessing survival outcomes of EWS in Upper Egypt, delineating factors of prognostic significance in comparison to other leading oncology centers in Egypt and internationally. By retrospectively reviewing medical records of 85 patients with a verified diagnosis of EWS in the period from 2001 to 2015 at Pediatric and Medical Oncology Departments at South Egypt Cancer Institute; We gathered data relevant to the patient, disease, and treatment variables of the study. Survival was estimated using the Kaplan Meier method and differences between various groups were determined by log rank test. Univariable and multivariable analyses were performed using Cox regression. With a median follow-up period of 62.7 months (95% CI 52.2-73.2, SE=5.4) for the study patients, the estimates of event-free survival (EFS) and overall survival (OS) at 3 and 5 years were 42.1% and 50.6%, and 40.8% and 48.5%, respectively. Metastatic disease at initial presentation (HR=8.91, 95% CI, 4.00-19.9; P<0.0001) stood as the most powerful predictor of OS in the multivariable analysis, followed by surgery used as a local modality (HR=0.16, 95% CI, 0.06-0.44; P=0.0004). Response to neoadjuvant chemotherapy (HR=2.61, 95% CI, 1.11-6.13; P=0.028), primary tumor size (HR=2.49, 95% CI, 1.03-6.03; P=0.044) were also shown to be significantly associated with OS. Radiotherapy as a local modality, whose effect, apparently shown to increase the hazard of events occurrence in the univariable analysis, an effect that was reversed to reveal EFS advantage (HR=0.41, 95% CI, 0.18-0.95; P=0.036) after control of other variables. With 5-year OS of 48.5%, our survival results were comparable to those previously published from Egypt; however, differences still exist between centers due to varied representative study samples. However, outcomes in Egypt in general are still inferior to internationally published studies.
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Affiliation(s)
- Ahmed Mohammed Morsy
- Pediatric Oncology, South Egypt Cancer Institute, Assiut UniversityAssiut, Egypt
| | - Salah Abdel-Hadi
- Pediatric Oncology, National Cancer Institute, Cairo UniversityCairo, Egypt
| | | | - Gamal Amira
- Surgical Oncology, National Cancer Institute, Cairo UniversityCairo, Egypt
| | | | | | | | | | | | - Alia Mohamed Attia
- Radiotherapy and Nuclear Medicine, South Egypt Cancer Institute, Assiut UniversityAssiut, Egypt
| | - Asmaa Salah
- Radiotherapy and Nuclear Medicine, South Egypt Cancer Institute, Assiut UniversityAssiut, Egypt
| | | | - Ayatallah Ali Yousseif
- Radiotherapy and Nuclear Medicine, South Egypt Cancer Institute, Assiut UniversityAssiut, Egypt
| | | | - Asmaa Hussein Fathy
- Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Sohag UniversitySohag, Egypt
| | - Yasmine Nagy Elwany
- Cancer Management and Research, Medical Research Institute, Alexandria UniversityAlexandria, Egypt
| | | | - Khaled Hassan Mosallam
- Orthopedic Surgery, Hand & Reconstructive Microsurgery, Faculty of Medicine, South Valley UniversityQena, Egypt
| | | | | | | | | | - Hanan Ahmed Eltyb
- Medical Oncology, South Egypt Cancer Institute, Assiut UniversityAssiut, Egypt
| | - Ahmed Mubarak Hefni
- Medical Oncology, South Egypt Cancer Institute, Assiut UniversityAssiut, Egypt
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18
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Saifuddin MSAH, Ng CY, Abdullah MS. Skull Base Primary Ewing Sarcoma: A Radiological Experience of a Rare Disease in an Atypical Location. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e930384. [PMID: 34089579 PMCID: PMC8196398 DOI: 10.12659/ajcr.930384] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Patient: Female, 4-year-old Final Diagnosis: Skull base Ewing’s sarcoma Symptoms: Gradual visual loss • inability to walk • near blindness • protrusion of eyes • seizure • vomiting • weight loss Medication: — Clinical Procedure: Biopsy of the left nasal mass • computed tomography of the brain • magnetic resonance imaging of the brain • nasoendoscope of the left nostril Specialty: Neurosurgery • Pediatrics and Neonatology • Radiology
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Affiliation(s)
| | - Chiak Yot Ng
- Radiology Unit, Medical-Based Department, Faculty of Medicine and Health Science, University of Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Mohd Shafie Abdullah
- Department of Radiology, School of Medical Sciences, University of Science Malaysia, Kota Bharu, Malaysia
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19
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Wei X, Zhang X, Song Z, Wang F. Analysis of Clinical, Imaging, and Pathologic Features of 36 Patients with Primary Intraspinal Primitive Neuroectodermal Tumors: A Case Series and Literature Review. J Neurol Surg A Cent Eur Neurosurg 2021; 82:526-537. [PMID: 33845511 DOI: 10.1055/s-0041-1723810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND AND STUDY AIMS Primary intraspinal primitive neuroectodermal tumors (PNETs) account for ∼0.4% of all intraspinal tumors, but information about these tumors in the medical literature is limited to single case reports. We report four cases of primary intraspinal PNETs and present a systematic literature review of the reported cases. MATERIALS AND METHODS We retrospectively reviewed and analyzed the clinical data of 4 patients with primary intraspinal PNETs who underwent neurosurgical treatment at our clinic between January 2013 and January 2020, and of 32 cases reported in the literature. RESULTS The female-to-male ratio was 2.6:1. The mean patient age was 21.42 ± 15.76 years (range: 1-60 years), and patients <36 years of age accounted for 83.30% of the study cohort. Progressive limb weakness and numbness were the chief symptoms (accounting for ∼55.6%). The mean complaint duration was 0.89 ± 0.66 months for males and 2.72 ± 3.82 months for females (p = 0.028). Epidural (41.7%) was the most common site, and thoracic (47.3%) was the most frequent location. Most PNETs were peripheral, and magnetic resonance imaging (MRI) appearance was isointense or mildly hypointense on T1-weighted images and hyperintense on T2-weighted images. Homogeneous contrast enhancement was observed. The 1-year survival rate of patients who underwent chemoradiation after total or subtotal lesion resection was better compared with patients who did not undergo chemotherapy, radiotherapy, or total or subtotal resection. The modality of treatment was associated with survival time (p = 0.007). CONCLUSION Primary intraspinal PNETs mainly occur in young people with a female preponderance. In patients with a rapid loss of lower limb muscle strength and large intraspinal lesions on MRI, PNETs should be considered. Surgical resection and adjuvant radio chemotherapy are key prognostic factors.
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Affiliation(s)
- Xuefeng Wei
- Department of Neurosurgery, Ningxia Medical University, Yinchuan, Republic of China
| | - Xu Zhang
- Department of Neurosurgery, Ningxia Medical University, Yinchuan, Republic of China
| | - Zimu Song
- Department of Neurosurgery, General Hospital Of NingXia Medical University, Yinchuan, Republic of China
| | - Feng Wang
- Department of Neurosurgery, General Hospital Of NingXia Medical University, Yinchuan, Republic of China.,Ningxia Key Laboratory of Cerebrocranial Diseases, Ningxia Medical University, Yinchuan, Republic of China
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20
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Han HM, Kim YC, Lee KJ, Kim TH. Resection of Ewing Sarcoma in the Paranasal Sinus Via the Endoscopic Modified Lothrop (Draf III) Approach. JOURNAL OF RHINOLOGY 2021. [DOI: 10.18787/jr.2020.00340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Ewing sarcoma is a rare type of bone tumor that typically occurs in the head and neck regions. Appropriate management strategies remain controversial. Herein, we report a case of Ewing sarcoma originating from the ethmoid sinus in a 38-year-old woman. The patient initially presented with unilateral nasal obstruction. Pathologic examination revealed a tumor composed of small round blue cells under hematoxylin and eosin staining with positive expressions for CD-99, CK, and FLI-1. The patient was successfully treated with neoadjuvant chemotherapy followed by complete surgical excision via the endoscopic modified Lothrop (Draf III) approach, adjuvant chemotherapy, and radiation therapy. There was no recurrence or complication up to the writing of this article. This study presents an appropriate management strategy for an extensive case of Ewing sarcoma invading the frontal sinus using an endoscopic approach.
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21
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Anne S, Malempati AR, Palanki G. Primary Ewing's sarcoma of the lung: a rare case report. Indian J Thorac Cardiovasc Surg 2020; 36:409-411. [PMID: 33061150 DOI: 10.1007/s12055-020-00936-x] [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: 11/30/2019] [Revised: 01/30/2020] [Accepted: 01/31/2020] [Indexed: 05/30/2023] Open
Abstract
The current case study had described the clinical presentation, evaluation, management, and outcome of a case of primary Ewing's Sarcoma of the lung. It was presented with cough, chest pain, and hemoptysis for 3 months in a 36-year-old male. Immunostaining of the sections prepared from the blocks using CD99 antibody revealed strong continuous cell membrane staining. Tumor cells showed negative staining for leukocyte common antigen (LCA), thyroid transcription factor 1 (TTF1), and pan-cytokeratin (AE1/AE3) consistent with extraskeletal Ewing's sarcoma (EES). Neoadjuvant chemotherapy of 6 cycles followed left lower lobectomy had led to good recovery and the patients are disease free at 18-month follow-up. Primary EES of the lung should be considered in the differential diagnosis when a young patient is presented with large mass without evidence of primary extrathoracic disease.
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Affiliation(s)
- Saipavan Anne
- Nizam's Institute of Medical Sciences, Hyderabad, Telangana India
| | | | - Gopal Palanki
- Nizam's Institute of Medical Sciences, Hyderabad, Telangana India
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22
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Pancaldi A, Peng L, Rhee DS, Dunn E, Forcucci JA, Belchis D, Pratilas CA. DICER1-associated metastatic abdominopelvic primitive neuroectodermal tumor with an EWSR1 rearrangement in a 16-yr-old female. Cold Spring Harb Mol Case Stud 2020; 6:mcs.a005603. [PMID: 33028642 PMCID: PMC7552927 DOI: 10.1101/mcs.a005603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/31/2020] [Indexed: 12/30/2022] Open
Abstract
We report a case of a DICER1-associated EWSR1-rearranged malignant primitive neuroectodermal tumor (PNET) arising in a patient with DICER1 tumor predisposition syndrome. A 16-yr-old female with a history of multinodular goiter presented with a widely metastatic abdominal small round blue cell tumor with neuroectodermal differentiation. EWSR1 gene rearrangement was identified in the tumor by fluorescence in situ hybridization (FISH). Genetic analysis revealed biallelic pathogenic DICER1 variation. The patient was treated with an aggressive course of chemotherapy, surgery, and radiation with complete pathologic response. We believe this case to represent a new expression of the DICER1 tumor predisposition syndrome, an entity caused by deleterious germline mutations in the DICER1 gene, encoding a ribonuclease active in the processing of miRNA. Patients with germline mutations in DICER1 develop a diverse group of benign and malignant tumors. Some of these tumors have been noted to have immature neuroepithelium as a component, including the ciliary body medulloepithelioma and the recently described DICER1-associated presacral malignant teratoid neoplasm. To our knowledge, abdominal sarcomas that resemble PNET histology with an EWSR1 rearrangement have not previously been described as a classical expression of the DICER1 syndrome phenotype.
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Affiliation(s)
- Alessia Pancaldi
- Post Graduate School of Pediatrics, Department of Medical and Surgical Sciences of the Mothers, Children and Adults, University of Modena and Reggio Emilia, 41124 Modena, Italy
| | - Lei Peng
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland 21231, USA
| | - Daniel S Rhee
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland 21231, USA.,Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Emily Dunn
- Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Jessica A Forcucci
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA
| | - Deborah Belchis
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA.,Doctor's Community Hospital, Lanham, Maryland 20706, USA
| | - Christine A Pratilas
- Division of Pediatric Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland 21231, USA
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23
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AlAhmadi HH, AlEssa A, Ahmed A, Al hamad MA, Fadaak K, El Darawany HM, Alhamam A, Al Dandan OS, Nabhan Abdelhameed AA, Alraqtan A. Primary ewing sarcoma/primitive neuroectodermal tumor of the kidney. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2020. [DOI: 10.1016/j.epsc.2020.101608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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24
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Strickland AL, Fadare O. Pediatric vulvar malignancies: rare but important to know. Semin Diagn Pathol 2020; 38:99-109. [PMID: 32943238 DOI: 10.1053/j.semdp.2020.09.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 11/11/2022]
Abstract
Malignancies of the vulva in the pediatric population are exceptionally rare, which makes it difficult to gain any insight into their clinicopathologic profile. In this review, we summarize all published cases of a vulva malignancy in pediatric patients (≤21 years) reported in the English language literature for the 50-year period between 1970 and 2020. We estimate that less than 100 malignancies have been reported in total, approximately 50% of which were rhabdomyosarcomas. Invasive squamous cell carcinomas, yolk sac tumors, Ewing sarcoma/primitive neuroectodermal tumors (ES/PNET) and melanomas each represented approximately 10% of reported cases. For rhabdomyosarcoma, the alveolar and embryonal subtypes were reported with equal frequency, with both representing 70% of cases combined. The average patient age was 9.8 years. 48% and 35% were Intergroup Rhabdomyosarcoma Study clinical groupings I and III respectively. Managements were generally multimodal, and overall outcomes for the group were favorable. For invasive squamous cell carcinoma, the patients were all in their teenage years, with an average age at diagnosis of 15.2 years. A small subset of cases were associated with human papillomavirus and immunosuppression, and it is possible that immunosuppression has a role in vulvar squamous carcinogenesis in this population. One case was associated with lichen sclerosus. The patients with yolk sac tumors ranged in age from less than 1 year to 20 years (mean 12) and 67% of cases were stage I at presentation. An insufficient number of cases have been reported to define their prognosis, although some cases were notably aggressive. The few reported cases of melanoma are distinctive only because they were all associated with lichen sclerosus, suggestive of some role for the latter in their pathogenesis. The average age of patients reported with ES/PNET was 15 years (range 3.3 to 20). At least half of the reported cases were advanced stage at presentation, and patient outcomes were notably poor: 62.5% were dead of disease at follow-up. Pediatric vulvar malignancies are rare and are mostly comprised of 5 entities. Their accurate pathologic classification is necessary to facilitate optimal management.
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Affiliation(s)
- Amanda L Strickland
- Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - Oluwole Fadare
- Department of Pathology, University of California San Diego, San Diego, CA, USA.
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25
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Woeste MR, Bhutiani N, Hong YK, Shah J, Kim W, E Egger M, Philips P, McMasters KM, Martin RCG, Scoggins CR. Primitive neuroectodermal tumor incidence, treatment patterns, and outcome: An analysis of the National Cancer Database. J Surg Oncol 2020; 122:1145-1151. [PMID: 32734604 DOI: 10.1002/jso.26139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Primitive neuroectodermal tumors (PNETs) comprise less than 1% of all sarcomas. The rarity of this disease has resulted in a paucity of information about disease process and management. This study sought to evaluate the incidence, treatment patterns, and outcomes among patients with PNET. METHODS The National Cancer Database was queried for diagnoses of PNET between 2004 and 2014. Patients were dichotomized based on tumor type (central [cPNET] vs peripheral [pPNET]). Demographic, tumor, treatment, and outcome variables were analyzed for the entire patient cohort and by type of PNET. RESULTS White (86.4%) males (56.6%) represented the majority of patients. The incidence of PNET remained stable over the study period (r2 = 0.0821). A total of 70.7% underwent surgical resection of the primary site, 50.3% received radiation, and 74.7% received systemic chemotherapy. Compared to those with pPNET, patients with cPNET more often received radiation treatment (P < .001), primary tumor resection (P < .001), and experienced increased 90-day mortality (P < .014). CONCLUSION cPNET and pPNET are rare and aggressive malignancies that tend to arise in White males. Multimodal treatment including surgery, chemotherapy, and radiation is conventional. Patients with cPNET more often receive radiation and primary tumor resection with increased 90-day mortality.
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Affiliation(s)
- Matthew R Woeste
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Neal Bhutiani
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Young K Hong
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky.,Department of Surgery, Division of Surgical Oncology, Cooper University Hospital, Camden, New Jersey
| | - Jasmit Shah
- Department of Population Health and Internal Medicine, Aga Khan University, Karachi, Pakistan
| | - Woihwan Kim
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Michael E Egger
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Prejesh Philips
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Kelly M McMasters
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Robert C G Martin
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
| | - Charles R Scoggins
- Division of Surgical Oncology, The Hiram C. Polk Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky
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26
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Abstract
A 22-year-old female presented with painful, progressive swelling of the right forearm for six months. Physical examination revealed a 7 cm x 5 cm firm, tender soft-tissue swelling over the anterior aspect of the right proximal forearm with normal overlying temperature. X-rays showed increased soft tissue shadow but without any bony involvement. Serum alkaline phosphatase, serum lactate dehydrogenase, and leukocyte count were raised. MRI of the right forearm revealed enhancing soft tissue lesion with internal hemorrhagic and necrotic components involving the flexor carpi radialis muscle. Core biopsy confirmed the diagnosis of extraosseus Ewing's sarcoma. Neoadjuvant chemotherapy, wide local tumor excision, and adjuvant chemotherapy and radiotherapy were done. The patient then lost to follow-up and presented again after six months with a fungating mass and neurovascular involvement for which an above-elbow amputation was done. We, through this case report, aim to discuss the clinical and radiological findings, line of management, and the importance of early detection and treatment and a regular follow-up for extraosseus Ewing's sarcoma of the extremity.
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Affiliation(s)
- Kuldeep Bansal
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Avijeet Prasad
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Pratyush Shahi
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Apoorv Sehgal
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
| | - Sushil Kamal
- Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, IND
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27
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Agnihotri M, Vaideeswar P. Rosettes-Diagnostic Feature of Askin Tumor on Cytology. Indian J Surg Oncol 2020; 11:451-452. [PMID: 33013126 DOI: 10.1007/s13193-020-01150-2] [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: 04/07/2020] [Accepted: 06/17/2020] [Indexed: 11/24/2022] Open
Abstract
Askin tumor is a rare malignant small round cell neoplasm of primitive neuroectodermal origin in the thoracopulmonary region, predominantly seen in childhood and adolescence. It belongs to the spectrum of Ewing's sarcoma family of tumors (ESFTs). Cytologically, ESFTs show small round cells with pseudorosettes. We report a case of an Askin tumor in an adult patient, diagnosed on fine-needle aspiration cytology. Clinico-radiological findings, immunochemistry, and cytogenetics help in confirming the diagnosis.
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Affiliation(s)
- Mona Agnihotri
- Department of Pathology, Seth GS Medical College & King Edward Memorial Hospital, Parel, Mumbai, 400012 India
| | - Pradeep Vaideeswar
- Department of Pathology, Seth GS Medical College & King Edward Memorial Hospital, Parel, Mumbai, 400012 India
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28
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Salah S, Abuhijla F, Ismail T, Yaser S, Sultan I, Halalsheh H, Shehadeh A, Abdelal S, Almousa A, Jaber O, Abu-Hijlih R. Outcomes of extraskeletal vs. skeletal Ewing sarcoma patients treated with standard chemotherapy protocol. Clin Transl Oncol 2020; 22:878-883. [PMID: 31429039 DOI: 10.1007/s12094-019-02202-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 08/09/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To compare the outcomes of extraskeletal and skeletal Ewing sarcomas treated with standard chemotherapy protocol. METHODS We retrospectively collected data on primary localized skeletal and extraskeletal ES patients. Demographics and disease characteristics were compared between the two groups. The influence of presentation (skeletal vs. extraskeletal) on overall survival (OS) and local recurrence-free survival (LRFS) was assessed and compared by the log-rank test. RESULTS A total of 120 patients were included; 29 (24%) had extraskeletal and 91 (76%) had skeletal ES. All patients received vincristine, doxorubicin, and cyclophosphamide alternating with ifosfamide and etoposide (VDC-IE) chemotherapy, with a plan for local control at week 12. At a median follow-up of 38 months, there was no difference in OS between skeletal and extraskeletal ES; 5-year OS 70% and 67% respectively, p = 0.96. Patients with extraskeletal ES had inferior 5-year LRFS compared to skeletal ES; 74% vs. 83%; p = 0.042. Local recurrence occurred at a higher frequency in the extraskeletal group; 28% vs. 11%, p = 0.034, although more extraskeletal patients received adjuvant radiotherapy; 73% vs. 36%, p = 0.01. Among patients who underwent surgery (n = 76), there was no difference in R0 resection rate (skeletal: 89%, extraskeletal: 86%, p = 0.52, or good ( ≥ 90%) tumor necrosis; skeletal: 54%, extraskeletal: 38%, p = 0.31. CONCLUSION Patients with localized extraskeletal ES have comparable OS outcomes to patients with skeletal ES utilizing the standard VDC-IE chemotherapy. However, extraskeletal patients are at significantly higher risk for local recurrence.
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Affiliation(s)
- S Salah
- Medical Oncology Department, King Hussein Cancer Center, Queen Rania Al Abdullah St 202, Amman, 11941, Jordan.
| | - F Abuhijla
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - T Ismail
- Department of Pediatric Oncology and Hematology, King Hussein Cancer Center, Amman, Jordan
| | - S Yaser
- Medical Oncology Department, King Hussein Cancer Center, Queen Rania Al Abdullah St 202, Amman, 11941, Jordan
| | - I Sultan
- Department of Pediatric Oncology and Hematology, King Hussein Cancer Center, Amman, Jordan
| | - H Halalsheh
- Department of Pediatric Oncology and Hematology, King Hussein Cancer Center, Amman, Jordan
| | - A Shehadeh
- Department of Orthopedic Surgery, King Hussein Cancer Center, Amman, Jordan
| | - S Abdelal
- Department of Orthopedic Surgery, King Hussein Cancer Center, Amman, Jordan
| | - A Almousa
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
| | - O Jaber
- Department of Pathology, King Hussein Cancer Center, Amman, Jordan
| | - R Abu-Hijlih
- Department of Radiation Oncology, King Hussein Cancer Center, Amman, Jordan
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29
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Nguyen TH, Makena MR, Yavvari S, Kaur M, Pham T, Urias E, Panapitiya N, Al-Rahawan MM. Sarcoma as Second Cancer in a Childhood Cancer Survivor: Case Report, Large Population Analysis and Literature Review. ACTA ACUST UNITED AC 2020; 56:medicina56050224. [PMID: 32392854 PMCID: PMC7279476 DOI: 10.3390/medicina56050224] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 12/25/2022]
Abstract
The majority of pediatric patients are cured of their primary cancer with current advanced developments in pediatric cancer therapy. However, survivors often experience long-term complications from therapies for primary cancer. The delayed mortality rate has been decreasing with the effort to reduce the therapeutic exposure of patients with pediatric cancers. Our study investigates the incidence of sarcoma as second cancer in pediatric cancer survivors. We present a 9-year-old male who survived embryonal hepatoblastoma diagnosed at 22 months of age. At 4.5 years of age, he presented with a non-metastatic primitive neuroectodermal tumor (PNET) of the left submandibular area. He has no evidence of recurrence of either cancer for 51 months after finishing all chemotherapy and radiotherapy. We used the Surveillance, Epidemiology, and End Results (SEER) database to identify the current rate of second sarcomas in pediatric cancer survivors. Our literature review and large population analysis emphasize the impact of sarcoma as a second malignancy and provide help to physicians caring for pediatric cancer survivors.
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Affiliation(s)
- Thinh H. Nguyen
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Monish Ram Makena
- Department of Physiology, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA;
| | - Siddhartha Yavvari
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, Usual;
| | - Maninder Kaur
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Teresia Pham
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Eduardo Urias
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Narendra Panapitiya
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
| | - Mohamad M. Al-Rahawan
- Department of Pediatrics, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX 79430, USA; (T.H.N.); (M.K.); (T.P.); (E.U.); (N.P.)
- Correspondence:
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Montoya C, Rey L, Rodríguez J, Fernández MJ, Troncoso D, Cañas A, Moreno O, Henríquez B, Rojas A. Epigenetic control of the EWS‑FLI1 promoter in Ewing's sarcoma. Oncol Rep 2020; 43:1199-1207. [PMID: 32323788 PMCID: PMC7057940 DOI: 10.3892/or.2020.7489] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 10/04/2019] [Indexed: 11/09/2022] Open
Abstract
Ewing sarcoma (ES) is a primary bone marrow tumor that very rarely develops in extra-osseous tissues, such as lung. The hallmark of ES tumors is a translocation between chromosomes 11 and 22, resulting in a fusion protein, commonly referred to as EWS-FLI1. The epigenetic profile (histone acetylation and methylation enrichment of the promoter region) that may regulate the expression of the aberrant transcription factor EWS-FLI1, remains poorly studied and understood. Knowledge of epigenetic patterns associated with covalent histone modification and expression of enzymes associated with this process, can contribute to the understanding of the molecular basis of the disease, as well as to the identification of possible molecular targets involved in expression of the EWS-FLI1 gene, so that therapeutic strategies may be improved in the future. In the present study, the transcriptional activation and repression of the EWS-FLI1 fusion gene in ES was accompanied by selective deposition of histone markers on its promoter. The EWS-FLI1 fusion gene was evaluated in two patients with ES using conventional cytogenetic, fluorescence in situ hybridization and nested PCR assays, which revealed that the aberrant expression of the EWS-FLI1 gene is accompanied by enrichment of H3K4Me3, H3K9ac and H3K27ac at the promoter region.
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Affiliation(s)
- C Montoya
- Institute of Human Genetics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá 110231, Colombia, Chile
| | - L Rey
- Institute of Human Genetics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá 110231, Colombia, Chile
| | - J Rodríguez
- Department of Pathology, Hospital Universitario San Ignacio, Bogotá 110231, Colombia, Chile
| | - M J Fernández
- Department of Physiological Sciences, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá 110231, Colombia, Chile
| | - D Troncoso
- Institute of Human Genetics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá 110231, Colombia, Chile
| | - A Cañas
- Department of Internal Medicine, Hospital Universitario San Ignacio, Bogotá 110231, Colombia, Chile
| | - O Moreno
- Institute of Human Genetics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
| | - B Henríquez
- Faculty of Medicine and Science, Universidad San Sebastián, Santiago 7510157, Chile
| | - A Rojas
- Institute of Human Genetics, Faculty of Medicine, Pontificia Universidad Javeriana, Bogotá 110231, Colombia
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Ravishankar H, Mangani AS, Shankar MB, Joshi M, Devasena T, Parameswaran S, Subramaniam K. Characterization of NCC-RbC-51, an RB cell line isolated from a metastatic site. Histochem Cell Biol 2019; 153:101-109. [DOI: 10.1007/s00418-019-01832-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2019] [Indexed: 02/07/2023]
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Vishnoi JR, Kumar V, Srivastava K, Misra S. Primary Ewing's sarcoma of the temporal bone: a rare entity and review of the literature. BMJ Case Rep 2019; 12:12/10/e230768. [PMID: 31645395 DOI: 10.1136/bcr-2019-230768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ewing's sarcoma (ES) is the second most common malignant primary bone tumour in children and adolescents. It primarily affects the diaphysis of long bones and pelvis. ES arising from temporal bone is extremely rare. To date, 43 such cases have been described in the literature. Clinical and radiological features are non-specific. Diagnosis is based mainly on immunohistochemistry. The present article presents an extremely rare case of ES of the temporal bone in a 20-year young man, and he was successfully treated with multiagent chemotherapy and radiotherapy.
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Affiliation(s)
- Jeewan Ram Vishnoi
- Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India .,Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vijay Kumar
- Surgical Oncology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Kirti Srivastava
- Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Sanjeev Misra
- Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
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Suhag S, Byrd RH, Jaiswal K. Rare Case of Thoracic Desmoplastic Small Round Cell Tumor in a Three-Year-Old Boy. J Oncol Pract 2019; 15:617-620. [PMID: 31618088 DOI: 10.1200/jop.19.00358] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Affiliation(s)
| | - Robert H Byrd
- University of Oklahoma School of Community Medicine, Tulsa, OK
| | - Kamna Jaiswal
- University of Oklahoma School of Community Medicine, Tulsa, OK
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Hsieh YH, Hsu YH, Lien CY, Liu CH, Li WT. Retroperitoneal extraosseous peripheral primitive neuroectodermal tumor in a Formosan serow: case report and literature review. J Vet Diagn Invest 2019; 31:883-888. [PMID: 31585511 DOI: 10.1177/1040638719879198] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
A 10-y-old female captive Formosan serow (Capricornis swinhoei) was inactive and was azotemic. An autopsy was performed following her death, and multiple irregularly shaped, white-to-gray masses of 0.5-2 cm diameter were noted on both ureters, the left adrenal gland, urinary bladder, and uterus. Microscopically, organs were effaced by a poorly demarcated, highly infiltrative neoplasm, composed of neoplastic round cells arranged in islands, sheets, or nests with occasional rosette formation. The neoplastic cells were small: ≤2 red blood cell (≤ 15 μm) diameter. The neoplastic cells were positive for CD56, CK, FLI-1, and NSE, but negative for desmin, GFAP, melan A, NF, PAX-8, S100, synaptophysin, and vimentin. Therefore, the diagnosis of retroperitoneal extraosseous peripheral primitive neuroectodermal tumor (pPNET) was made. pPNET with FLI-1 expression has not been reported previously in animals, to our knowledge.
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Affiliation(s)
- Yu-Han Hsieh
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan (Hsieh, Liu, Li).,Department of Pathology, Hualien Tzu Chi Hospital and Buddhist Tzu Chi University, Hualien, Taiwan (Hsu).,Taipei Zoo, Taipei, Taiwan (Lien).,Fishhead Labs, Stuart, FL (Li)
| | - Yung-Hsiang Hsu
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan (Hsieh, Liu, Li).,Department of Pathology, Hualien Tzu Chi Hospital and Buddhist Tzu Chi University, Hualien, Taiwan (Hsu).,Taipei Zoo, Taipei, Taiwan (Lien).,Fishhead Labs, Stuart, FL (Li)
| | - Chen-Yeh Lien
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan (Hsieh, Liu, Li).,Department of Pathology, Hualien Tzu Chi Hospital and Buddhist Tzu Chi University, Hualien, Taiwan (Hsu).,Taipei Zoo, Taipei, Taiwan (Lien).,Fishhead Labs, Stuart, FL (Li)
| | - Chen-Hsuan Liu
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan (Hsieh, Liu, Li).,Department of Pathology, Hualien Tzu Chi Hospital and Buddhist Tzu Chi University, Hualien, Taiwan (Hsu).,Taipei Zoo, Taipei, Taiwan (Lien).,Fishhead Labs, Stuart, FL (Li)
| | - Wen-Ta Li
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, Taipei, Taiwan (Hsieh, Liu, Li).,Department of Pathology, Hualien Tzu Chi Hospital and Buddhist Tzu Chi University, Hualien, Taiwan (Hsu).,Taipei Zoo, Taipei, Taiwan (Lien).,Fishhead Labs, Stuart, FL (Li)
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A Rare Case of Gastric Metastasis in Ewing's Sarcoma of the Femur. Case Rep Oncol Med 2019; 2019:2870302. [PMID: 31218087 PMCID: PMC6537017 DOI: 10.1155/2019/2870302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 05/07/2019] [Indexed: 12/11/2022] Open
Abstract
The stomach is a very unusual site of metastasis. Published reports on metastatic lesion in the stomach is generally limited to single case reports and case series. Gastric metastasis in an Ewing's sarcoma is extremely rare and has been reported in English literature but once to our knowledge. We present a case report of Ewing's sarcoma of the right proximal femur metastasizing to the stomach. A young female treated for Ewing's sarcoma of the femur in 2012 presented with gastric metastasis after four years of disease-free interval. She was treated with irinotecan-based chemotherapy followed by total gastrectomy with esophagojejunal anastomosis and radiation therapy. At one-year follow-up, she was disease free.
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36
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Adamantinoma-Like Ewing's Family Tumor of the Sino Nasal Region: A Case Report and a Brief Review of Literature. Case Rep Pathol 2019; 2019:5158182. [PMID: 31249713 PMCID: PMC6530217 DOI: 10.1155/2019/5158182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 03/23/2019] [Accepted: 04/14/2019] [Indexed: 12/20/2022] Open
Abstract
Ewing's sarcoma family of tumors (EFTs) are malignant mesenchymal tumors with a predilection for bone and soft tissue. They are characterized by their monomorphic small blue round cell morphology. However rare morphologic variants of EFTs can also show overt epithelial differentiation in the form of squamoid differentiation along with strong cytokeratin expression. This particular subset of EFTs are known as adamantinoma-like EFTs which can be difficult to differentiate from epithelial head and neck malignancies. Here we report a case of sinonasal adamantinoma-like EFT in an 18-year-old male patient. The lesion differed from a typical EFT by means of overt squamoid differentiation which showed a basaloid appearance with peripheral palisading. The immunohistochemistry was positive for pan-cytokeratin, p40, p63, ERG, FLI1, and CK5/6. It was negative for actin, desmin, and WT-1. Initial diagnosis of a basaloid squamous cell carcinoma was made. Further molecular studies were also done due to the complex presentation of the tumor. EWSR testing with break-apart analysis confirmed EWSR1 and FLI1 rearrangements. Further confirmation was done with RT-PCR. The case was found to be positive for EWS-FLI-1 translocation. The revised immunohistochemistry panel showed CD99, ERG, FLI1, and synaptophysin positivity. The lesion was reclassified as an adamantinoma-like ES. Our case reinforces the fact that a subset of EFTs can show histomorphologic and immunohistochemical features of aberrant epithelial differentiation. These cases are difficult to differentiate from usual epithelial malignancies which occur in this region. This diagnostic pitfall can be avoided by the inclusion of CD99 and/or FLI1 in the immunohistochemical assessment of any round cell malignancy at any anatomic location. A strong and diffuse CD99 positivity should prompt molecular testing for the presence of EWSR1 gene rearrangements.
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Savvidou OD, Koutsouradis P, Chloros GD, Papanastasiou I, Sarlikiotis T, Kaspiris A, Papagelopoulos PJ. Bone tumours around the elbow: a rare entity. EFORT Open Rev 2019; 4:133-142. [PMID: 31057950 PMCID: PMC6491951 DOI: 10.1302/2058-5241.4.180086] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Bone tumours around the elbow are rare. Even nowadays diagnostic dilemmas and delays are common. During recent decades the management and prognosis of patients with elbow bone tumours has improved significantly.Benign tumours can be treated using minimally invasive procedures, whereas malignant ones require a multidisciplinary team approach based on an adjuvant therapeutic regimen of chemotherapy, radiotherapy and limb salvage procedures.This article reviews the most commonly encountered elbow bone tumours and their management. Cite this article: EFORT Open Rev 2019;4:133-142. DOI: 10.1302/2058-5241.4.180086.
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Affiliation(s)
- Olga D Savvidou
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 'ATTIKON' Hospital, Athens, Greece
| | | | - George D Chloros
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 'ATTIKON' Hospital, Athens, Greece
| | - Ioannis Papanastasiou
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 'ATTIKON' Hospital, Athens, Greece
| | - Thomas Sarlikiotis
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 'ATTIKON' Hospital, Athens, Greece
| | - Aggelos Kaspiris
- Laboratory of Molecular Pharmacology/ Sector for Bone Research, School of Health Sciences, University of Patras, Patras, Greece
| | - Panayiotis J Papagelopoulos
- First Department of Orthopaedic Surgery, National and Kapodistrian University of Athens, 'ATTIKON' Hospital, Athens, Greece
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Alvarez-SanNicolas J, Gracia-Alegria I, Trullols-Tarrago L, Peiro-Ibañez A, Lamas-Gomez C. Prognostic factors and survival in Ewing's sarcoma treated by limb salvage surgery. Clin Transl Oncol 2019; 21:1374-1382. [PMID: 30798513 DOI: 10.1007/s12094-019-02067-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/15/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE Survival in Ewing's sarcoma (ES) has increased with the use of chemotherapy. Surgical techniques such as limb salvage (LS) have been developed. Survival and adverse events have been widely studied in general series of ES, but there are few specific series of ES cases treated by LS, despite this being the most commonly used (surgical) approach. The aim of this study was to determine survival and prognostic factors in ES patients undergoing LS. PATIENTS AND METHODS We analysed all ES patients treated between January 1984 and May 2008 and selected all those treated by systemic multimodal therapy and LS. We assessed the influence of patient characteristics, tumour parameters and therapeutic results in event-free survival (EFS). RESULTS Ninety patients were included. Fifty of them were treated by systemic multimodal therapy and locally by LS. ean age was 20 years. Overall survival (OS) was 68.8% and EFS was 60.6% at years. In the univariate analysis, pelvic location, age and response to chemotherapy were associated with poor prognosis. After multivariate analysis, poor response to treatment, pelvis location and age between 12 and 17 years were found to be independent prognostic factors. Dissemination at diagnosis was not a prognostic factor. CONCLUSIONS OS and EFS in ES treated by LS were similar to findings in previous ES studies. factors are no different, except for the presence of metastasis at diagnosis.
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Affiliation(s)
- J Alvarez-SanNicolas
- Department of Orthopaedic Surgery, Hospital Sant Joan Despí Moisès Broggi, C/ Jacint Verdaguer, 08970, Sant Joan Despí, Barcelona, Spain.
| | - I Gracia-Alegria
- Department of Oncological Orthopaedic Surgery, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - L Trullols-Tarrago
- Department of Oncological Orthopaedic Surgery, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - A Peiro-Ibañez
- Department of Oncological Orthopaedic Surgery, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Lamas-Gomez
- Department of Orthopaedic Surgery, Hospital de La Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
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Astekar M, Saxena S, Murari A, Manjunatha BS. Ewing's sarcoma in maxilla. BMJ Case Rep 2019. [PMID: 30796079 DOI: 10.1136/bcr-2018-227819.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ewing sarcoma is a lesion of bone, described in small round cell neoplasm. This tumour resembles primitive neuroectodermal tumour both clinically and histologically. Major difference between these two is that the former arises in the bone and the later in soft tissue. It appears most frequently in males at the age range of of 5-25 years, 80% of which occurs within first two decades of life. Males are more commonly affected than females. Present paper reported with a case report of male patient with 24-year-old showing Ewing's sarcoma of right maxilla.
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Affiliation(s)
- Madhusudan Astekar
- Oral and Maxillofacial Pathology, Institute of Dental Sciences, Rohailkhand University, Bareilly, Uttar Pradesh, India
| | - Shipra Saxena
- Oral and Maxillofacial Pathology, Institute of Dental Sciences, Rohailkhand University, Bareilly, Uttar Pradesh, India
| | - Aditi Murari
- Oral and Maxillofacial Pathology, Institute of Dental Sciences, Rohailkhand University, Bareilly, Uttar Pradesh, India
| | - Bhari Sharanesha Manjunatha
- Dental Anatomy and Oral Biology, Division of Basic Dental Sciences, Faculty of Dentistry, Taif University, Al Taif, Saudi Arabia
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40
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Abstract
Ewing sarcoma is a lesion of bone, described in small round cell neoplasm. This tumour resembles primitive neuroectodermal tumour both clinically and histologically. Major difference between these two is that the former arises in the bone and the later in soft tissue. It appears most frequently in males at the age range of of 5-25 years, 80% of which occurs within first two decades of life. Males are more commonly affected than females. Present paper reported with a case report of male patient with 24-year-old showing Ewing's sarcoma of right maxilla.
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Affiliation(s)
- Madhusudan Astekar
- Oral and Maxillofacial Pathology, Institute of Dental Sciences, Rohailkhand University, Bareilly, Uttar Pradesh, India
| | - Shipra Saxena
- Oral and Maxillofacial Pathology, Institute of Dental Sciences, Rohailkhand University, Bareilly, Uttar Pradesh, India
| | - Aditi Murari
- Oral and Maxillofacial Pathology, Institute of Dental Sciences, Rohailkhand University, Bareilly, Uttar Pradesh, India
| | - Bhari Sharanesha Manjunatha
- Dental Anatomy and Oral Biology, Division of Basic Dental Sciences, Faculty of Dentistry, Taif University, Al Taif, Saudi Arabia
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Majeed SS, Muhammad HA, Ali JS, Khudhair HH, Said A, Arif SO, Murad KM, Gendari AH, Muhsin BM, Mohammed SA, Mula-Hussain L. Treatment Outcomes of Pediatric Patients With Ewing Sarcoma in a War-Torn Nation: A Single-Institute Experience From Iraq. J Glob Oncol 2019; 5:1-9. [PMID: 30707662 PMCID: PMC6426536 DOI: 10.1200/jgo.18.00122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
PURPOSE Ewing sarcoma (ES) is a relatively rare, highly malignant tumor of the musculoskeletal system. It is the second most common malignant bone tumor in children and adolescents in the age group of 5 to 20 years. The aim of this study was to identify the treatment outcomes of pediatric patients with ES in Sulaimani governorate, Iraq. PATIENTS AND METHODS This was a retrospective study that reviewed the medical records of pediatric patients with ES who were managed between 2009 and 2015, with follow-up until late 2017. Patient- and tumor-related factors were correlated with clinical outcomes. RESULTS A total of 31 pediatric patients with ES were included in this study. All the patients received chemotherapy and radiotherapy, whereas only 14 patients underwent surgical resection and just eight had free surgical margins. The median age at diagnosis was 13 years, 58% were male, and 42% were female. The presenting symptoms at diagnosis were mostly pain (67.7%) and palpable mass (25.8%). The primary tumor was located in the extremities (51.6%), the thoracic cage (19.4%), the pelvis (16.1%), and the lumbar vertebrae (12.9%). Approximately two thirds of the patients (61.3%) had localized disease at the time of presentation. The 5-year overall survival was 19%, and the 5-year recurrence-free survival was 34%. CONCLUSION Clinical outcomes of ES in pediatric patients in our war-torn nation, Iraq, are still markedly inferior to the published outcomes from stable, developed nations. Additional large and multicenter national studies are required. Diagnostic and therapeutic measures need improvement, and multidisciplinary and comprehensive cancer-integrated approaches are vital for better outcomes.
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Affiliation(s)
| | - Hawzheen A Muhammad
- Komar University of Science and Technology, Sulaimani, Kurdistan, Iraq.,University of Sulaimani, Sulaimani, Kurdistan, Iraq
| | - Jalil S Ali
- Zhianawa Cancer Center, Sulaimani, Kurdistan, Iraq
| | | | - Ayah Said
- University of Toronto, Toronto, Ontario, Canada
| | - Shkar O Arif
- Zhianawa Cancer Center, Sulaimani, Kurdistan, Iraq
| | | | - Ali H Gendari
- Mosul Oncology and Nuclear Medicine Hospital, Mosul, Ninevah, Iraq
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Rahbar M, Rahbar M, bahoush G. Peripheral primitive neuroectodermal tumor associated with paraneoplastic Cushing's syndrome: The rare case. Ann Med Surg (Lond) 2018; 37:21-24. [PMID: 30581565 PMCID: PMC6287080 DOI: 10.1016/j.amsu.2018.11.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 11/25/2018] [Indexed: 12/16/2022] Open
Abstract
Introduction Primitive neuroectodermal tumors (PNET) form a group of tumors defined by their appearance that are thought to develop from primitive (undifferentiated) nerve cells in the brain. They are rare tumors and their incidence is not well defined. Case presentation An 18-month-old male presenting with typical Cushingoid appearance (moon face, central obesity, hirsutism and growth arrest) was admitted for evaluation of endocrine problems. Subsequent laboratory studies revealed markedly elevated adrenocorticotropic (ACTH) and cortisol levels, as well as a hypokalemic metabolic alkalosis, these data are consistent with the diagnosis of Cushing's disease. He was treated with metyrapone to control hypercortisolemia. One month and a half later, a mass was detected in the abdomen by ultrasonography. An abdominal Computed tomography confirmed a large heterogeneous retroperitoneal mass with a significant amount of extension into surrounding structures which was removed by laparoscopic abdominal surgery. The patient's symptoms completely resolved and the ACTH and cortisol levels were also greatly reduced. Histologically, the tumor tissue consistent with the diagnosis of the retroperitoneal primitive neuroectodermal tumor which was confirmed immunohistochemically. This case demonstrates the successful diagnosis and treatment of a rare neoplasm. Conclusion This is the first rare case with ectopic ACTH syndrome caused by the peripheral primitive neuroectodermal tumor. Paraneoplastic Cushing's syndrome has been attributed to ectopic ACTH secretion. Primitive neuroectodermal tumor secret ectopic ACTH and make Cushing's syndrome. Our case is an 18-month-old male presenting Cushing's syndrome because of retroperitoneal primitive neuroectodermal tumor. After remove of tumor,the patient's symptoms completely resolved.
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Affiliation(s)
- Mahtab Rahbar
- Iran University of Medical Science, Tehran, Iran
- Corresponding author. Tel.: +98 2122435412.
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Louati S, Senhaji N, Chbani L, Bennis S. EWSR1 Rearrangement and CD99 Expression as Diagnostic Biomarkers for Ewing/PNET Sarcomas in a Moroccan Population. DISEASE MARKERS 2018; 2018:7971019. [PMID: 30319719 PMCID: PMC6167566 DOI: 10.1155/2018/7971019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/16/2018] [Accepted: 08/18/2018] [Indexed: 11/23/2022]
Abstract
Ewing sarcoma/primitive neuroectodermal tumor (Ewing/PNET sarcomas or EPS) are a group of round cell tumors. Malignant round cell tumors form a large and diverse group that includes rhabdomyosarcoma, synovial sarcoma, non-Hodgkin's lymphoma, neuroblastoma, hepatoblastoma, Wilm's tumor, desmoplastic small round cell tumor, and other morphologically similar entities. Differential diagnosis of Ewing sarcoma/primitive neuroectodermal tumor (Ewing/PNET sarcomas or EPS) is difficult. In addition to morphology and immunohistochemistry (IHC), differential diagnosis of these tumors is based on molecular analysis of the EWSR1 gene rearrangement using fluorescent in situ hybridization (FISH) technique. We investigated the diagnostic value of combined CD99 immunostaining and EWSR1 t(22q12) alteration using a dual-color, break-apart rearrangement probe in forty-one formalin-fixed paraffin-embedded (FFPE) tissue samples from pediatric and adult patients diagnosed with EPS. IHC was performed in all cases using the CD99 antibody and showed a positivity of 92.7% in the enrolled cases (38/41) followed by FISH analysis where 48.8% of the cases (20/41) were rearranged. Sensitivity and specificity for IHC assays were 88% and 58%, respectively. Notably, FISH had a sensitivity of 100% and a specificity of 87%. In addition, CD99 positivity was found to correlate with EWSR1 rearrangement (p < 0.05). This report shows that FISH has better sensitivity and specificity than IHC in the Moroccan population, and supports its combination with CD99 immunostaining as diagnostic biomarkers for this rare malignant entity."
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Affiliation(s)
- Sara Louati
- Bioactive Molecules, Structure and Functions Laboratory, Faculty of Sciences and Techniques, Sidi Mohamed ben Abdellah University of Fez, Morocco
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
| | - Nadia Senhaji
- Bioactive Molecules, Structure and Functions Laboratory, Faculty of Sciences and Techniques, Sidi Mohamed ben Abdellah University of Fez, Morocco
| | - Laila Chbani
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed ben Abdellah University of Fez, Morocco
| | - Sanae Bennis
- Pathological Anatomy and Molecular Pathology Department, Hassan II University Hospital of Fez, Morocco
- Biomedical and Translational Research Laboratory, Faculty of Medicine and Pharmacy, Sidi Mohamed ben Abdellah University of Fez, Morocco
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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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45
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Ocular retinoblastoma and neuroblastoma: A cytological impression. JOURNAL OF SURGERY AND MEDICINE 2018. [DOI: 10.28982/josam.430299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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46
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van Koevering K, Prevedello DM, Carrau RL. Endoscopic endonasal approaches for the management of cranial base malignancies: histologically guided treatment and clinical outcomes. J Neurosurg Sci 2018; 62:667-681. [PMID: 29808637 DOI: 10.23736/s0390-5616.18.04507-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Malignancies of the skull base represent a highly diverse and challenging set of pathologies which exhibit a wide array of oncologic behavior. In recent decades, a number of important advances in treatment technique have evolved to improve oncologic outcomes and reduce morbidity in the treatment of these aggressive cancers. Intensity modulated radiation therapy has become the gold standard in radiotherapy owing to its precision planning and reduced morbidity. However heavy ion particle radiation (proton therapy, carbon ion, etc.) are recently emerging with promising results at the skull base related to the reduced exit dose to adjacent structures. Novel systemic therapeutics such as targeted and immunotherapies may dramatically alter the treatment paradigm for many of these pathologies. Nevertheless, most skull base malignancies remain surgical diseases. The evolution of the expanded endonasal approach for a minimally invasive surgical resection has proven validity in treating many of these pathologies when properly selected, and have largely supplanted open approaches owing to the reduced morbidity profile. In spite of these important advances, the most critical aspect in comprehensive treatment is a detailed understanding of the oncologic behavior and outcomes data for each of the specific histopathologies encountered at the skull base. The nuances in management strategy, histologic profile, and surveillance planning can be stratified through the development of a comprehensive, multidisciplinary skull base team to maximize therapeutic effect and minimize morbidity for each patient. This review aims to summarize the key body of data and approaches for each of the histologies frequently encountered in the skull base, while highlighting the value and technique of endonasal approaches.
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Affiliation(s)
- Kyle van Koevering
- Department of Otolaryngology, Head and Neck Surgery, Wexner Medical Center, Ohio State University, Columbus, OH, USA
| | - Daniel M Prevedello
- Department of Neurosurgery, Wexner Medical Center, Ohio State University, Columbus, OH, USA
| | - Ricardo L Carrau
- Department of Neurosurgery, Wexner Medical Center, Ohio State University, Columbus, OH, USA -
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Extraskeletal versus Skeletal Ewing Sarcoma in the adult population: Controversies in care. Surg Oncol 2018; 27:373-379. [PMID: 30217290 DOI: 10.1016/j.suronc.2018.05.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/03/2018] [Accepted: 05/10/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES A lack of consensus exists on the prognosis of extraskeletal Ewing sarcoma (EES) relative to its skeletal (ES) counterpart in adults. This study sought to characterize outcome differences between the two diagnoses. METHODS From 2004 to 2014, the NCDB identified 2,660 Ewing Sarcoma patients. Cox proportional hazards regression analysis was used to identify risk factors for overall survival (OS). RESULTS EES patients were older, more likely to be female, and have smaller tumors. Among patients with ES, 4.0% received no treatment, 2.5% received local therapy only (surgery and/or radiation), 16.8% received chemotherapy only, while 52.2% received combination therapy (local and chemotherapy), and 17.0% recieived triple therapy (surgery, radiation and chemotherapy). Among patients with EES, 4.3% recived no treatment, 5.6% received local therapy only, 15.6% received chemotherapy only, while 47.0% received combination therapy, and 21.6% received triple therapy. No difference in OS was observed between the two groups (P = 0.816). Factors independently associated with OS for ES included age (HR = 1.26, P = 0.01), Charlson-Deyo Score (CDS) ≥2 (HR = 3.66, P < 0.001), combination therapy (HR = 0.39, P < 0.001) and triple therapy (HR = 0.34, P < 0.001). For EES, factors for OS were age (HR = 1.52, P < 0.001), CDS ≥2 (HR = 1.90, P = 0.02), combination therapy (HR = 0.44, P < 0.001), triple therapy (HR = 0.34, P < 0.001) and PNET histology (HR = 1.33, P = 0.02). CONCLUSIONS Demographic, histological, and treatment characteristics differ between adult patients diagnosed with ES and ESS. However, survival and independent predictors of survival are consistent between the two diagnoses.
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Sharma AD, Singh J, Bhattacharya J. Primary Ewing's Sarcoma of Cranium in a Pediatric Patient. J Pediatr Neurosci 2017; 12:273-275. [PMID: 29204207 PMCID: PMC5696669 DOI: 10.4103/jpn.jpn_29_17] [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: 11/29/2022] Open
Abstract
Ewing's sarcoma primarily involving the skull is an unusual occurrence (1% of all Ewing's sarcoma cases) with very few reported cases in the published literature. The challenge in such cases is to establish a definitive diagnosis before starting the multidisciplinary treatment approach. We report such a rare case in a 13-year-old boy who is being treated at our institute with an intention of adding to the limited information we currently have on diagnosis, management, and the outcome of such cases.
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Affiliation(s)
- Ashutosh Das Sharma
- Department of Radiotherapy, The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - Jayesh Singh
- Department of Radiotherapy, The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - Jigna Bhattacharya
- Department of Radiotherapy, The Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
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Feki J, Guermazi Z, Kammoun B, Khanfir A, Toumi N, Boudawara T, Boudawara Z, Daoud J, Frikha M. Ewing's sarcoma of the cranial vault: a case report. Acta Clin Belg 2017; 72:443-446. [PMID: 28287344 DOI: 10.1080/17843286.2017.1300989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Ewing's sarcoma is a malignant tumor that mainly affects young patients. It represents 10% of primary malignant tumors of the bone and 3% of malignant tumors of the child. Cranial localization is extremely rare representing less than 1% of all the localizations. We report a case of a 10-year-old girl who presented with an intracranial hypertension syndrome with left parietal mass of progressive installation. The X-ray skull showed a lytic lesion with irregular margins involving the left parietal bone. Brain magnetic resonance imaging revealed extensive parietal bone destruction involving both the inner and outer tables. The girl was operated in emergency. Histological examination concluded to Ewing's Sarcoma. The resection was incomplete (R1). The girl received induction's chemotherapy. The cerebral scanner evaluation showed no abnormalities. Then, she received consolidation's chemotherapy with concomitant local radiation therapy. Currently, the girl is in complete remission with a seven-month decline.
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Affiliation(s)
- Jihene Feki
- Department of Oncology and Radiotherapy, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Zeineb Guermazi
- Department of Oncology and Radiotherapy, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Brahim Kammoun
- Department of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Afef Khanfir
- Department of Oncology and Radiotherapy, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Nabil Toumi
- Department of Oncology and Radiotherapy, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Tahiya Boudawara
- Department of Pathology, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Zaher Boudawara
- Department of Neurosurgery, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Jamel Daoud
- Department of Radiotherapy, Habib Bourguiba University Hospital, Sfax, Tunisia
| | - Mounir Frikha
- Department of Oncology and Radiotherapy, Habib Bourguiba University Hospital, Sfax, Tunisia
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50
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Primary Occipital Ewing's Sarcoma with Subsequent Spinal Seeding. Case Rep Pediatr 2017; 2017:1521407. [PMID: 28690908 PMCID: PMC5485299 DOI: 10.1155/2017/1521407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 05/01/2017] [Accepted: 05/23/2017] [Indexed: 11/18/2022] Open
Abstract
Ewing's sarcoma is a primary bone cancer that mainly affects the long bones. This malignancy is particularly common in pediatric patients. Primary cranial involvement accounts for 1% of cases, with occipital involvement considered extremely rare. In this case study, primary occipital Ewing's sarcoma with a posterior fossa mass and subsequent relapse resulting in spinal seeding is reported. A 3-year-old patient presented with a 1-year history of left-sided headaches, localized over the occipital bone with progressive torticollis. Computed tomography (CT) imaging showed a mass in the left posterior fossa compressing the brainstem. The patient then underwent surgical excision followed by adjuvant chemoradiation therapy. Two years later, the patient presented with severe lower back pain and urinary incontinence. Whole-spine magnetic resonance imaging (MRI) showed cerebrospinal fluid (CSF) seeding from the L5 to the S4 vertebrae. Primary cranial Ewing's sarcoma is considered in the differential diagnosis of children with extra-axial posterior fossa mass associated with destructive permeative bone lesions. Although primary cranial Ewing's sarcoma typically has good prognosis, our patient developed metastasis in the lower spine. Therefore, with CNS Ewing's sarcoma, screening of the entire neural axis should be taken into consideration for early detection of CSF seeding metastasis in order to decrease the associated morbidity and mortality.
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