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Salama H, Abu-Hilal LH, Idkedek M, Kharousha A, Abulihya M, Nimer H. Primary extraskeletal intradural Ewing sarcoma with acute hemorrhage: a case report and review of the literature. J Med Case Rep 2024; 18:144. [PMID: 38459600 PMCID: PMC10924417 DOI: 10.1186/s13256-024-04384-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 01/14/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Spinal cord tumors present a challenge in diagnosis and treatment due to their varied histopathological characteristics. While Ewing sarcoma is a rare malignant tumor typically originating from skeletal bone, cases of primary intradural extraskeletal Ewing sarcoma are exceptionally rare. The similarity of its presentation to other spinal tumors further complicates its identification and management. CASE PRESENTATION We report a case of a 58-year-old Palestinian male with intradural extraskeletal lumbar Ewing sarcoma. The patient initially presented with lower back pain and bilateral S1 radiculopathy, with more severe symptoms on the left side. Magnetic resonance imaging revealed a 7 cm oval-shaped mass with homogeneous contrast enhancement, obstructing the spinal canal from L3/L4 to L5/S1 levels. Initially, a myxopapillary ependymoma was suspected, but the patient's sensory and motor functions suddenly deteriorated during hospitalization. Repeat magnetic resonance imaging indicated heterogeneous contrast enhancement, indicating acute intratumoral hemorrhage. Consequently, the patient underwent emergent L3-L5 laminotomy, with successful gross total resection of the tumor. Histopathological and immunohistochemical analyses confirmed the diagnosis of intradural extraskeletal Ewing sarcoma. Adjuvant therapy was administered to minimize the risk of local recurrence or distant metastasis. A systematic review of relevant literature, along with retrospective analysis of medical records, operative reports, radiological studies, and histopathological findings of similar cases, was also conducted. CONCLUSIONS Intradural extraskeletal Ewing sarcoma is an infrequently encountered condition in adult patients, emphasizing the importance of considering it in the differential diagnosis of spinal tumors. Surgeons must possess a comprehensive understanding of this rare entity to ensure accurate staging and optimal management, particularly in the early stages when prompt intervention may improve prognosis.
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Affiliation(s)
- HusamEddin Salama
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Lila H Abu-Hilal
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine.
| | - Mayar Idkedek
- Medical Research Club, Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Abdalwahab Kharousha
- Department of Neurosurgery, Al-Istishari Arab Hospital, Ramallah, West Bank, Palestine
| | - Mohand Abulihya
- Department of Pathology, Al-Istishari Arab Hospital, Ramallah, West Bank, Palestine
| | - Hafez Nimer
- Department of Neurosurgery, Al-Istishari Arab Hospital, Ramallah, West Bank, Palestine
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AlMuammar SA. A 13-Year-Old Boy with Chest Wall Actinomycosis Mimicking Ewing Sarcoma on Imaging. Am J Case Rep 2023; 24:e941498. [PMID: 37919883 PMCID: PMC10630588 DOI: 10.12659/ajcr.941498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND Actinomyces, a filamentous, branching, anaerobic gram-positive bacillus, typically found as a commensal organism in the oral cavity, can lead to rare chronic bacterial infections in various anatomical regions. Chest wall involvement represents an uncommon presentation, posing significant diagnostic challenges. This report focuses on the case of a 13-year-old boy presenting with chest wall actinomycetoma that closely resembled Ewing sarcoma on imaging. CASE REPORT We present the case of a 13-year-old male with no previous medical history who presented to the Emergency Department with progressive left-sided chest pain following a sports-related fall. Physical examination revealed mild swelling and tenderness on the left anterior chest wall. A chest computed tomography (CT) scan revealed a large tumor involving the lower left chest wall, suggesting Ewing sarcoma. However, a histopathological examination unexpectedly confirmed actinomycosis of the chest wall. Intravenous penicillin G was promptly initiated for 4 weeks. A follow-up CT scan after 4 weeks of therapy demonstrated a significant response with notable reduction in the size of the chest wall mass. The patient then continued with maintenance therapy using oral amoxicillin for 12 months. Throughout this period, complete resolution of the chest wall mass occurred, with no significant adverse events or complications observed. CONCLUSIONS This case highlights the importance of considering uncommon differential diagnoses like chest wall actinomycosis in patients presenting with chest wall masses. The diagnostic complexities associated with this rare condition emphasize the need for a comprehensive evaluation strategy, incorporating histopathological examination and imaging.
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Affiliation(s)
- Sarah A AlMuammar
- Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Niño-Taravilla C, Zuleta-Morales Y, Otaola-Arca H, Montenegro B, Sotomayor F C, Greppi Q C, Silva Garay P, Ortiz-Fritz P. Successful extracorporeal membrane oxygenation therapy in a child with coronavirus 2019 disease-associated ARDS and chemotherapy for Ewing's sarcoma. Perfusion 2023; 38:1742-1745. [PMID: 36117471 PMCID: PMC9483655 DOI: 10.1177/02676591221127570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Most children and adolescents with SARS-CoV-2 infection show no or mild symptoms, but those with medical histories can be susceptible to more severe forms of disease. There are few reported cases of extracorporeal membrane oxygenation (ECMO) in pediatric patients with coronavirus disease 2019 (COVID-19). We present a previously healthy 13-year-old male diagnosed with metastatic Ewing's sarcoma at the same time as catastrophic acute respiratory distress syndrome due to COVID-19, who was successfully supported by venovenous-ECMO while he received the corresponding chemotherapy protocol.ECMO can be used as salvage therapy in oncology pediatric patients with respiratory failure secondary to COVID-19. In addition, successful chemotherapy can be administered while patients are supported on ECMO.
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Affiliation(s)
- Carmen Niño-Taravilla
- Pediatric Intensive Care Unit, Hospital de Niños Roberto del
Rio, Santiago, Chile
- Pediatric Intensive Care Unit, Clínica Indisa, Santiago, Chile
- Faculty of Medicine, Andrés Bello University, Santiago, Chile
| | - Yuri Zuleta-Morales
- Pediatric Intensive Care Unit, Hospital de Niños Roberto del
Rio, Santiago, Chile
| | - Hugo Otaola-Arca
- Department of Urology, Clínica Alemana de
Santiago, Santiago, Chile
- Faculty of Medicine, Clínica Alemana-Universidad del
Desarrollo, Santiago, Chile
| | - Benigno Montenegro
- Pediatric Intensive Care Unit, Hospital de Niños Roberto del
Rio, Santiago, Chile
- Pediatric Oncology Service, Hospital de Niños Roberto del
Rio, Santiago, Chile
| | | | - Claudia Greppi Q
- Pediatric Oncology Service, Hospital de Niños Roberto del
Rio, Santiago, Chile
| | - Pamela Silva Garay
- Pediatric Oncology Service, Hospital de Niños Roberto del
Rio, Santiago, Chile
| | - Paula Ortiz-Fritz
- Pediatric Intensive Care Unit, Hospital de Niños Roberto del
Rio, Santiago, Chile
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Kadan-Lottick NS, Zheng DJ, Wang M, Bishop MW, Srivastava DK, Ross WL, Rodwin RL, Ness KK, Gibson TM, Spunt SL, Okcu MF, Leisenring WM, Robison LL, Armstrong GT, Krull KR. Patient-reported neurocognitive function in adult survivors of childhood and adolescent osteosarcoma and Ewing sarcoma. J Cancer Surviv 2023; 17:1238-1250. [PMID: 35059962 PMCID: PMC9300774 DOI: 10.1007/s11764-021-01154-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 12/02/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE Little is known regarding long-term neurocognitive outcomes in osteosarcoma and Ewing sarcoma (EWS) survivors despite potential risk factors. We evaluated associations among treatment exposures, chronic health conditions, and patient-reported neurocognitive outcomes in adult survivors of childhood osteosarcoma and EWS. METHODS Five-year survivors of osteosarcoma (N = 604; median age 37.0 years) and EWS (N = 356; median age 35.0 years) diagnosed at < 21 years from 1970 to 1999, and 697 siblings completed the Childhood Cancer Survivor Study Neurocognitive Questionnaire and reported chronic health conditions, education, and employment. Prevalence of reported neurocognitive difficulties were compared between diagnostic groups and siblings. Modified Poisson regression identified factors associated with neurocognitive difficulties. RESULTS Osteosarcoma and EWS survivors, vs. siblings, reported higher prevalences of difficulties with task efficiency (15.4% [P = 0.03] and 14.0% [P = 0.04] vs. 9.6%, respectively) and emotional regulation (18.0% [P < 0.0001] and 15.2% [P = 0.03] vs. 11.3%, respectively), adjusted for age, sex, and ethnicity/race. Osteosarcoma survivors reported greater memory difficulties vs. siblings (23.5% vs. 16.4% [P = 0.01]). Comorbid impairment (i.e., ≥ 2 neurocognitive domains) was more prevalent in osteosarcoma (20.0% [P < 0.001]) and EWS survivors (16.3% [P = 0.02]) vs. siblings (10.9%). Neurological conditions were associated with worse task efficiency (RR = 2.17; 95% CI = 1.21-3.88) and emotional regulation (RR = 1.88; 95% CI = 1.01-3.52), and respiratory conditions were associated with worse organization (RR = 2.60; 95% CI = 1.05-6.39) for EWS. Hearing impairment was associated with emotional regulation difficulties for osteosarcoma (RR = 1.98; 95% CI = 1.22-3.20). Patient report of cognitive difficulties was associated with employment but not educational attainment. CONCLUSIONS Survivors of childhood osteosarcoma and EWS are at increased risk for reporting neurocognitive difficulties, which are associated with employment status and appear related to chronic health conditions that develop over time. IMPLICATIONS FOR CANCER SURVIVORS Early screening, prevention, and treatment of chronic health conditions may improve/prevent long-term neurocognitive outcomes.
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Affiliation(s)
- Nina S Kadan-Lottick
- Cancer Prevention and Control Program, Georgetown Lombardi Comprehensive Cancer Center, 2115 Wisconsin Ave., NW - 3Rd Floor, Washington, DC, 20007, USA.
| | - Daniel J Zheng
- Divisions of Hematology and Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Mingjuan Wang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Michael W Bishop
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Deo Kumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Wilhelmenia L Ross
- Section of Pediatric Hematology-Oncology, Yale University School of Medicine, New Haven, CT, USA
| | - Rozalyn L Rodwin
- Section of Pediatric Hematology-Oncology, Yale University School of Medicine, New Haven, CT, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Todd M Gibson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sheri L Spunt
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Mehmet Fatih Okcu
- Department of Pediatrics, Section of Hematology-Oncology, Baylor College of Medicine, Houston, TX, USA
| | | | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
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Yang YC, Liu ASH. Primary epidural lumbar Ewing sarcoma presenting as cauda equina syndrome in an adult patient who underwent surgical decompression: A case report. Neurocirugia (Astur : Engl Ed) 2022; 33:237-241. [PMID: 36084959 DOI: 10.1016/j.neucie.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/01/2021] [Indexed: 06/15/2023]
Abstract
Ewing sarcoma (ES) is a rare primary neoplasm in the lumbar adult spine and may mimic a benign tumor. In this case, after a patient's three-month history of lower back pain and rapidly progressing leg numbness and weakness, magnetic resonance imaging (MRI) showed a mass in the third lumbar vertebra. At a two-month follow-up, imaging showed a fracture, compression and lesion enlargement. Decompression and fixation confirmed ES, and the patient began combined radiotherapy and chemotherapy. Two months postoperatively, residual ES was suspected on MRI. The patient underwent a second surgery, and histopathology confirmed necrosis. A six-month follow-up after the first surgery showed no tumor recurrence. This case supports the inclusion of ES in the differential diagnosis of pathologic spinal fracture. Early decompression and spinal fixation are critical for preserving neurologic and spinal functions in ES complicated by a compression fracture. Combined adjuvant radiotherapy and chemotherapy remain the standard therapeutic strategy.
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Affiliation(s)
- Yao-Chung Yang
- Division of Neurosurgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; National Defense Medical Center, Taipei, Taiwan
| | - Andrew Szu-Hao Liu
- Division of Neurosurgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
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Villanueva G, Sampor C, Moreno F, Alderete D, Moresco A, Pinto N, Szijan I, Schaiquevich P, Felice MS, Rose A, Zubizarreta P, Sgroi M, Fandiño A, Chantada G. Subsequent malignant neoplasms in the pediatric age in retinoblastoma survivors in Argentina. Pediatr Blood Cancer 2022; 69:e29710. [PMID: 35451226 DOI: 10.1002/pbc.29710] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/02/2022] [Accepted: 03/21/2022] [Indexed: 01/17/2023]
Abstract
BACKGROUND Retinoblastoma survivors in low- and middle-income countries are exposed to high-intensity treatments that potentially place them at higher risk of early subsequent malignant neoplasms (SMNs). METHODS We followed 714 (403 [56.4%] nonhereditary and 311 [43.5%] hereditary) retinoblastoma survivors diagnosed from August 1987 to December 2016, up to the age of 16 years. We quantified risk of SMNs with cumulative incidence (CI) and standardized incidence ratios (SIR) analysis. Multivariate regression Cox model was used to determine the association of treatments and risk of SMNs. RESULTS Median follow-up was of 9 years (range: 0.18-16.9) and 24 survivors (3.36%) developed 25 SMNs (n = 22 hereditary, n = 2 nonhereditary). SMNs included sarcomas (osteosarcomas, Ewing sarcomas, rhabdomyosarcomas; n = 12), leukemias (n = 5), and central nervous system tumors (CNS; n = 3). All cases of acute myeloid leukemia (AML) and most of Ewing sarcomas occurred within 5 years of retinoblastoma diagnosis. The type of SMN was the main indicator of mortality (five of five patients with leukemias, six of 12 with sarcomas, and zero of three with CNS tumors died). Compared to the general population, radiation increased the risk of Ewing sarcoma in hereditary survivors by 700-fold (95% CI = 252-2422.6) and chemotherapy increased the risk of AML by 140-fold (95% CI = 45.3-436). The CI of SMNs for hereditary survivors was 13.7% (95% CI = 8.4-22.1) at 15 years. CONCLUSION Retinoblastoma survivors from Argentina are at higher risk of developing SMNs early in life compared to the general Argentinean population, especially those treated with radiation plus chemotherapy. AML and Ewing sarcoma presented within 5 years of retinoblastoma diagnosis are associated with chemotherapy and radiation exposure.
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Affiliation(s)
- Gabriela Villanueva
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Claudia Sampor
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Florencia Moreno
- Instituto Nacional del Cáncer, Registro Onco-pediatrico Hospitalario Argentino (ROHA), Buenos Aires, Argentina
| | - Daniel Alderete
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Angelica Moresco
- Department of Genetics, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Natalia Pinto
- Department of Radiotherapy, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Irene Szijan
- Cátedra de Genética, Facultad de Farmacia y Bioquímica, Hospital de Clínicas, University of Buenos Aires, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Paula Schaiquevich
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - María Sara Felice
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Adriana Rose
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Pedro Zubizarreta
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Mariana Sgroi
- Ophthalmology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Adriana Fandiño
- Ophthalmology Department, Hospital JP Garrahan, Buenos Aires, Argentina
| | - Guillermo Chantada
- Hematology and Oncology Department, Hospital JP Garrahan, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
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Karguppikar MB, Oza CM, Khadilkar V, Khadilkar A. Rare case of renal Ewing sarcoma presenting as ectopic Cushing syndrome in a 12-year-old girl. BMJ Case Rep 2022; 15:e246751. [PMID: 35131789 PMCID: PMC8823052 DOI: 10.1136/bcr-2021-246751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/04/2022] Open
Abstract
We present a 12-year-old girl with recent onset weight gain and purple striae over the abdomen. Examination revealed her to be hypertensive. On evaluation for Cushing syndrome (CS), her cortisol and adrenocorticotropic hormone (ACTH) were found to be high. MRI brain showed a suspicious lesion (thought to be pituitary microadenoma). Inferior petrosal sinus sampling was not conclusive of pituitary source of ACTH. High dose dexamethasone suppression test confirmed an ectopic source of ACTH secretion and CT scan revealed a mass in the right kidney which was laparoscopically excised. Histopathology and immunohistochemistry confirmed Ewing sarcoma. Our case highlights the rare presentation of renal Ewing sarcoma (RES) as CS. To the best of our knowledge, this is only the second case report of RES/primitive neuroectodermal tumour of the kidney presenting as CS in paediatric age group and first with a concomitant pituitary incidentaloma.
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Affiliation(s)
- Madhura Bharat Karguppikar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Chirantap Markand Oza
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
| | - Vaman Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
| | - Anuradha Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Pune, Maharashtra, India
- Interdisciplinary School of Health Sciences, Savitribai Phule Pune University, Pune, Maharashtra, India
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Kuni SP, Gupta N, Cherath SK, Das A, Agrawal S, Ish P, Kumar R, Chakrabarti S. A 22-Year-Old Man With Back Pain, Dilated Veins Over Chest, and Mass in Right Atrium. Chest 2021; 158:e335-e341. [PMID: 33280779 DOI: 10.1016/j.chest.2020.07.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 07/12/2020] [Accepted: 07/17/2020] [Indexed: 11/19/2022] Open
Abstract
CASE PRESENTATION A 22-year-old nonsmoker male, without any previous comorbidity, presented with 4 months' history of right upper back pain. Pain was constant dull aching type, nonpleuritic, aggravated by lying on the right lateral side and partially relieved on taking analgesics. He then developed progressive dyspnea over 2 months and noticed dilated veins over his neck and front of chest. There was associated unintentional weight loss of 6 kg. There was no history of cough, expectoration, wheeze, or hemoptysis, nor any episodes of night sweats or fever.
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Affiliation(s)
- Shamil Pannivettum Kuni
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Nitesh Gupta
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
| | - Smrithi Krishna Cherath
- Pathlab-Centre for Advanced Pathology and Microbiology Services, East of Kailash, New Delhi, India
| | - Abanti Das
- Department of Radiodiagnosis, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Sumita Agrawal
- Department of Pulmonary Medicine, Medipulse Hospital, Jodhpur, Rajasthan, India
| | - Pranav Ish
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Rohit Kumar
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Shibdas Chakrabarti
- Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Abstract
RATIONALE Extra osseous Ewing sarcoma (ES), an uncommon malignant neoplasm, accounts for about 15% of Ewing sarcoma, which mainly affects paravertebral region, lower extremity, chest wall, retroperitoneum, pelvis, and hip. Here is a 54-year-old woman of primary vaginal Ewing sarcoma with uterine fibroid, which has been fewly known or reported. PATIENT CONCERNS The patient was admitted to our hospital because of vaginal pain. Her uterus showed as parallel position and enlarged as about 3 months of pregnancy size. DIAGNOSIS Magnetic resonance imaging (MRI) and ultrasonography (US) demonstrated 2 heterogeneous masses in the vagina and uterus, respectively. Ultrasound-guided puncture biopsy revealed a malignant tumor in the right lateral vaginal wall. INTERVENTIONS The patient was treated by hysterectomy, bilateral salpingo-oophorectomy, and tumors excision, with the subsequent treatment of chemotherapy. OUTCOMES The patient recovered well without local recurrence for >1 year. LESSONS Primary vaginal Ewing sarcoma is extremely rare. The treatments of uterine fibroid include uterine artery embolization and surgical options, While wide local excision followed by adjuvant chemotherapy and/or radiotherapy should be recommended for the vaginal ES.
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Affiliation(s)
| | | | | | - Hongbin Wang
- Department of Gynecological Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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10
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Kalra SK, Sali AP, Somal PK, Sancheti S. Pericardial Fluid Cytology: A Rosettey Affair…. Acta Cytol 2020; 64:507-510. [PMID: 32252050 DOI: 10.1159/000506726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 11/19/2022]
Affiliation(s)
| | - Akash Pramod Sali
- Department of Pathology, Homi Bhabha Cancer Hospital, Sangrur, India
| | - Puneet Kaur Somal
- Department of Pathology, Homi Bhabha Cancer Hospital, Sangrur, India
| | - Sankalp Sancheti
- Department of Pathology, Homi Bhabha Cancer Hospital, Sangrur, India,
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11
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Nagi M, Ang D, Farrah J, Gray D. Ewing's Sarcoma Family Tumor (EFT) Presents as Spontaneous Splenic Rupture. Am Surg 2019; 85:e460-e464. [PMID: 31638539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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12
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Zaldivar-Jolissaint JF, Bobinski L, Duff JM. Multilevel Pedicular Osteotomies for En Bloc Resection of a Primary Ewing Sarcoma of the Subaxial Cervical Spine with Pedicle Screw Reconstruction. World Neurosurg 2019; 132:303-308. [PMID: 31394361 DOI: 10.1016/j.wneu.2019.07.208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 07/28/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Primary Ewing sarcoma of the mobile spine is a rare disease. Its management requires careful surgical planning, because radical, margin-free excision is directly correlated with prognosis. Extensive bone removal in the cervical spine can lead to instability and cause postoperative iatrogenic cervical deformity. Thus, spinal instrumentation plays an important role in restoring postresection spinal stability and improving quality of life. METHODS We present a novel technique that allows successful removal of a large Ewing sarcoma of the subaxial cervical spine, infiltrating and traversing the posterior bone elements, and extending into the paraspinal muscles. This technique involves radical en bloc resection of posteriorly located cervical tumors via multilevel pediculotomy, with terminal vertebrae pedicle screw reconstruction. RESULTS Terminal vertebrae cervical pedicle screw reconstruction allowed wide surgical excision with satisfactory oncologic and mechanical results. CONCLUSIONS This technique enables 1-stage total tumor resection and stabilization and may be a viable alternative to radical en bloc resection of posteriorly located epidural malignant lesions of the cervical spine in selected cases.
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Affiliation(s)
| | - Lukas Bobinski
- Spine Unit, Department of Orthopedic Surgery, University Hospital of Umea, Umea, Sweden
| | - John Michael Duff
- Neurosurgery Department, Clinique de Genolier, Genolier, Switzerland
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13
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Giuliani E, Ellman EM, Chugh R, Moravek MB. Successful embryo cryopreservation immediately following a full-term delivery in a woman with newly diagnosed Ewing's sarcoma. J Assist Reprod Genet 2019; 36:1023-1028. [PMID: 30953232 DOI: 10.1007/s10815-019-01445-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 03/27/2019] [Indexed: 11/24/2022] Open
Affiliation(s)
- Emma Giuliani
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5276, USA
| | - Erin M Ellman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5276, USA
| | - Rashmi Chugh
- Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Molly B Moravek
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5276, USA.
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Lee MJ, Kang MH, Yeom JH, Yeom H, Seong M, Cho H, Shin YU. Compressive optic neuropathy secondary to Ewing sarcoma in the paranasal sinus: A case report. Medicine (Baltimore) 2018; 97:e13027. [PMID: 30383663 PMCID: PMC6221559 DOI: 10.1097/md.0000000000013027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Ewing sarcoma localized in the paranasal sinuses, compressing the optic nerve, is very rare, with no prior case reports PATIENT CONCERNS:: A 68-year-old woman presented with decreased visual acuity in her left eye and paresthesia of the left face. Brain magnetic resonance imaging showed heterogeneously enhancing mass in the left paranasal sinuses with adjacent bone destruction, extending to the extraocular muscles and optic nerve of the left orbit. A biopsy of the nasal cavity confirmed Ewing sarcoma. DIAGNOSIS Compressive optic neuropathy secondary to Ewing sarcoma in the paranasal sinuses. INTERVENTION Neoadjuvant chemotherapy and radiotherapy were performed. OUTCOMES Resolution of the tumor and increased visual acuity and field of the left eye. LESSONS Primary head and neck Ewing sarcoma can lead to compressive optic neuropathy, but the tumor responded well to the chemotherapy. Early diagnosis and immediate treatment by close cooperation between the ophthalmologist and oncologist can prevent from permanent visual loss.
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Affiliation(s)
| | | | - Jong Hun Yeom
- Department of Anesthesiology and Pain Medicine, Hanyang University College of Medicine, Seoul, Korea
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15
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Oron G, Eitan R, Goldchmit C, Ash S, Rabinerson D, Garor R, Sapir O, Abir R, Yeoshoua E, Ben-Haroush A, Shufaro Y, Wiznitzer A, Fisch B. [LAPAROSCOPICALLY-ASSISTED ULTRASOUND-GUIDED PERCUTANEOUS TRANSABDOMINAL OOCYTE COLLECTION: FERTILITY PRESERVATION IN A 17-YEARS-OLD GIRL WITH VAGINAL EWING SARCOMA]. Harefuah 2018; 157:21-23. [PMID: 29374868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Options for preserving fertility in children and adolescents with cancer depend on patient age, the available time frame, and the treatment regimen. Ovarian stimulation with mature oocyte preservation is often the optimal method in post-menarcheal adolescents. We describe a case of a 17-year-old girl with vaginal soft-tissue Ewing sarcoma in whom transvaginal oocyte collection for fertility preservation was ruled out by the large tumor. To overcome the limitations of the transabdominal approach, we applied a novel method of laparoscopically-assisted ultrasound-guided percutaneous transabdominal oocyte collection. In this manner, we were able to both perform oophorectomy and obtain superficial and deep ovarian follicles for cryopreservation.
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Affiliation(s)
- Galia Oron
- Infertility and IVF Unit, Beilinson Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Ram Eitan
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Chen Goldchmit
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Shifra Ash
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Rabinerson
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Roni Garor
- Infertility and IVF Unit, Beilinson Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Onit Sapir
- Infertility and IVF Unit, Beilinson Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Ronit Abir
- Infertility and IVF Unit, Beilinson Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Effi Yeoshoua
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Avi Ben-Haroush
- Infertility and IVF Unit, Beilinson Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Yoel Shufaro
- Infertility and IVF Unit, Beilinson Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Arnon Wiznitzer
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
| | - Benjamin Fisch
- Infertility and IVF Unit, Beilinson Hospital for Women, Rabin Medical Center, Petach Tikva, Israel
- Pediatric Oncology Department, Schneider Hospital for Children, Petach Tikva, Israel
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16
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Ruiz-Pinto S, Pita G, Patiño-García A, Alonso J, Pérez-Martínez A, Cartón AJ, Gutiérrez-Larraya F, Alonso MR, Barnes DR, Dennis J, Michailidou K, Gómez-Santos C, Thompson DJ, Easton DF, Benítez J, González-Neira A. Exome array analysis identifies GPR35 as a novel susceptibility gene for anthracycline-induced cardiotoxicity in childhood cancer. Pharmacogenet Genomics 2017; 27:445-453. [PMID: 28961156 DOI: 10.1097/fpc.0000000000000309] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Pediatric cancer survivors are a steadily growing population; however, chronic anthracycline-induced cardiotoxicity (AIC) is a serious long-term complication leading to considerable morbidity. We aimed to identify new genes and low-frequency variants influencing the susceptibility to AIC for pediatric cancer patients. PATIENTS AND METHODS We studied the association of variants on the Illumina HumanExome BeadChip array in 83 anthracycline-treated pediatric cancer patients. In addition to single-variant association tests, we carried out a gene-based analysis to investigate the combined effects of common and low-frequency variants to chronic AIC. RESULTS Although no single-variant showed an association with chronic AIC that was statistically significant after correction for multiple testing, we identified a novel significant association for G protein-coupled receptor 35 (GPR35) by gene-based testing, a gene with potential roles in cardiac physiology and pathology (P=7.0×10), which remained statistically significant after correction for multiple testing (PFDR=0.03). The greatest contribution to this observed association was made by rs12468485, a missense variant (p.Thr253Met, c.758C>T, minor allele frequency=0.04), with the T allele associated with an increased risk of chronic AIC and more severe symptomatic cardiac manifestations at low anthracycline doses. CONCLUSION Using exome array data, we identified GPR35 as a novel susceptibility gene associated with chronic AIC in pediatric cancer patients.
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Affiliation(s)
- Sara Ruiz-Pinto
- aHuman Genotyping Unit-CeGen bHuman Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO) cPediatric Solid Tumor Laboratory, Human Genetic Department, Research Institute of Rare Diseases, Instituto de Salud Carlos III dDepartment of Pediatric Hemato-Oncology eDepartment of Pediatric Cardiology, Hospital Universitario La Paz fDepartment of Pediatrics, Hospital Universitario Infanta Elena, Madrid gDepartment of Pediatrics, University Clinic of Navarra, Universidad de Navarra, Pamplona, Spain hDepartment of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology iDepartment of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK jDepartment of Electron Microscopy/Molecular Pathology, Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
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17
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Liu C, Cui LG, Wang HL. Renal Ewing's sarcoma/primitive neuroectodermal tumor: a case report and literature review. Beijing Da Xue Xue Bao Yi Xue Ban 2017; 49:919-923. [PMID: 29045981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ewing's sarcoma/primitive neuroectodermal tumor (EWS/PNET) in the kidney is a rare but high-grade malignant tumor that affects predominantly elder children and adolescents. Patients mostly present with nonspecific symptoms such as abdominal pain and gross hematuria. Since EWS/PNET has a rapid clinical progression with early metastasis and death, it is essential to make an accurate and early diagnosis. Once diagnosed, multimodality treatment, including radical surgery combined with adjuvant chemotherapy, and radiotherapy if necessary, is recommended. Unfortunately, there are no characteristic signsthat have been described in ultrasonography or any other imaging modalities so far. The diagnosis of EWS/PNET is now based on a classical histological and immunohistochemical investigation complemented by a demonstration of specific chromosomal changes. Strong immunoreactivity to CD99 is ubiquitous, and t(11;22) translocation is seen in approximately 90% of EWS/PNET. Herein, we report a patient with such condition. The patient was a young woman, and she presented with sudden right flank pain clinically. Ultrasonography revealed a large heterogeneous mass in the lower pole of her right kidney. The tumor compressed the renal pelvis and led to upper pole caliectasis. Color Doppler demonstrated blood flow with a pulsatile arterialized waveform within the mass. The patient received radical nephrectomy with right renal vein and vena cava thrombectomy. A search for other sites of tumor involvement yielded negative results. And six cycles of chemotherapy were sequentially performed. The diagnosis of EWS/PNET was confirmed based on primitive small round cell histology and characteristic immunohistochemical results. She was still alive with no evidence of recurrence five years after initial diagnosis. We would like to point out that ultrasound is still a useful method for initial assessment, and ultrasound-guided fine needle aspiration may play an important role in determining preoperative diagnosis.
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Affiliation(s)
- C Liu
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - L G Cui
- Department of Ultrasound, Peking University Third Hospital, Beijing 100191, China
| | - H L Wang
- Department of Radiology, Peking University Third Hospital, Beijing 100191, China
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18
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Corbella M, Brandolini M, Cambieri P, Decembrino N, Pagani M, Bottazzi A, Muzzi A, Zecca M, Mariani B, Marone P. A catheter-related bloodstream infection caused by Chryseobacterium indologenes successfully treated with antibiotic-lock rescue therapy. New Microbiol 2017; 40:223-225. [PMID: 28675244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 07/31/2017] [Indexed: 06/07/2023]
Abstract
We report the case of a catheter-related bloodstream infection caused by Chryseobacterium indologenes, an uncommon and multi-resistant pathogen, in a pediatric patient with a long-term vascular access device placed for chemotherapy treatment. The infection was successfully treated with ciprofloxacin antibiotic-lock therapy. This is the first report on successful salvage of a long-term device colonized by multi-resistant Chryseobacterium indologenes.
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Affiliation(s)
- Marta Corbella
- Servizio di Biometria ed Epidemiologia Clinica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- S.C. Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Micaela Brandolini
- S.C. Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Patrizia Cambieri
- S.C. Microbiologia e Virologia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Nunzia Decembrino
- S.C. Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Michele Pagani
- S.C. Anestesia e Rianimazione 2, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Andrea Bottazzi
- S.C. Anestesia e Rianimazione 2, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Alba Muzzi
- Direzione Medica di Presidio, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Marco Zecca
- S.C. Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Bianca Mariani
- S.C. Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Piero Marone
- S.C. Oncoematologia Pediatrica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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19
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Cernat E, Docquier PL, Paul L, Banse X, Codorean IB. Patient Specific Instruments for Complex Tumor Resection-Reconstruction Surgery within the Pelvis: A Series of 4 Cases. Chirurgia (Bucur) 2017; 111:439-444. [PMID: 27819644 DOI: 10.21614/chirurgia.111.5.439] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2016] [Indexed: 11/23/2022]
Abstract
The pelvis bone resection-reconstruction surgery is one of the most challenging fields in orthopedics. Being applied for tumors, as for other complex reconstruction cases, this type of surgery needs careful planning and is time consuming, in order to obtain proper accuracy. Unfortunately not all the time the expected accuracy is met, with consequences for the patients. PSI proved to provide good cutting accuracy during simulated tumor surgery within the pelvis. This article present a series of 4 patients operated in our department between June 2014 and Mars 2015 for tumors resectionreconstructions. The patients were imaged using a CT and an MRI scan and the images were reconstructed in 3D. According to the bone bank stock, the most similar allograft was chosen and the stored CT scan was reconstructed in 3D. Patient specific instruments (PSI) were designed and manufactured using rapid-prototyping technology for the resection of the native tissues as for the resection of the careful selected hemipelvic allografts. Allografts fitting to the pelvis of the patients was excellent and allowed stable osteosynthesis.
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20
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Turki S, Kedous S, Mahjoubi M, Dhambri S, Attia Z, Touati S. Primary Ewing's sarcoma of the sphenoid sinus with orbital and intracranial extension: a case report. Tunis Med 2016; 94:687. [PMID: 28994872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Ewing's sarcoma is a high-grade neuroectodermal primary bone tumor. This is the second primary bone tumor in children afterosteosarcoma and represents 4 to10% of cases. It can occur in all skeletal bones. However, the location at the facial bones is uncommon (1to2%) and extremely rare at the sphenoid sinus. We report the clinical results of a rare case of Ewing's sarcoma of the sphenoid with intraorbitaland intracranial extension.
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21
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Abstract
We prospectively investigated anti-Müllerian hormone (AMH) as a measure of ovarian insult in young females during and after treatment for Wilms tumor (WT), osteosarcoma (OS), and Ewing sarcoma (ES).Twenty-one female childhood cancer patients, with a mean age of 7.9 years (range 0.6-17), entered the study. Levels of AMH, follicle-stimulating hormone (FSH), and luteinizing hormone were monitored at diagnosis and every 3 to 4 months during, and regularly for a mean of 2.6 years after treatment.A profound decline in AMH was seen in the majority of the 21 study patients 3 to 4 months after the beginning of treatment, the exception being patients with WT, of whom 60% showed no such decline. During the remaining treatment, all patients except those with WT not treated with whole abdominal radiotherapy or stem cell transplantation (SCT) had AMH below detection limit.After completion of treatment, patients with OS and WT (without whole abdominal radiotherapy and SCT) recovered in AMH and had FSH in the normal range. In contrast, ES patients showed no AMH recovery and highly fluctuating FSH in the first years of follow-up, except for the 2 youngest patients, who had a late, slow AMH recovery.In conclusion, young female ES patients already showed signs of severe ovarian dysfunction during the first years after cancer treatment similar to patients treated with SCT and abdominal radiotherapy, in contrast to females with WT and OS. Fertility counseling and information concerning fertility preservation procedures should be considered before starting to treat young females with ES.
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Affiliation(s)
- Helena Mörse
- Department of Pediatrics, Pediatric Oncology and Hematology
- Correspondence: Helena Mörse, Department of Pediatrics, Pediatric Oncology and Hematology, Skane University Hospital, Lund University, Lund, Sweden (e-mail: )
| | | | - Aleksandra Turkiewicz
- Department of Orthopedics, Clinical Epidemiology Unit, Skane University Hospital, Lund University, Lund, Sweden
| | - Claus Yding Andersen
- Laboratory of Reproductive Biology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ingrid Øra
- Department of Pediatrics, Pediatric Oncology and Hematology
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22
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Naselli A, Garaventa A, Buffa P, Granata C, Bandettini R, Cangemi G, Moscatelli A, Castagnola E. Primary intestinal mold infection in children with solid tumors: a case report in an adolescent with Ewing sarcoma, and literature review. New Microbiol 2016; 39:232-234. [PMID: 27284990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 09/07/2016] [Indexed: 06/06/2023]
Abstract
We report a case of primary intestinal infection due to filamentous fungi in an adolescent with Ewing sarcoma. The clinical picture was that of peritonitis secondary to intestinal perforation and the diagnosis was established only on histopathological bases. This condition is very rare, and only one case of primary intestinal mold infection in children with solid tumors has been reported in the literature, although more records can be found describing similar conditions in other cancer patient populations (i.e. adults with solid tumors or children with hematological malignancies or patients receiving hemopoietic stem cell transplant). Clinicians must be aware of this possibility since only an aggressive medical and surgical approach can improve patients' prognosis.
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Affiliation(s)
- Aldo Naselli
- Infectious Diseases Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Alberto Garaventa
- Hematology and Oncology Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Piero Buffa
- Surgery Unit, Istituto Giannina Gaslini, Genoa, Italy
| | - Claudio Granata
- Radiology Department, Istituto Giannina Gaslini, Genoa, Italy
| | | | | | | | - Elio Castagnola
- Infectious Diseases Unit, Istituto Giannina Gaslini, Genoa, Italy
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23
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Gowdy SC, Paterson A, McCarthy A. Medical image. Pain and swelling in a child's thumb. Ewing sarcoma. N Z Med J 2014; 127:80-81. [PMID: 25530335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- S Claire Gowdy
- Royal Belfast Hospital for Sick Children, 180 Falls Road, Belfast BT12 6BE, UK.
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24
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Zhao M, Zhang B, Liang F, Zhang J. Primary spinal intradural extraskeletal Ewing sarcoma mimicking a giant nerve sheath tumor: case report and review of the literature. Int J Clin Exp Pathol 2014; 7:9081-9085. [PMID: 25674292 PMCID: PMC4314022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/18/2014] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
Abstract
Primary intradural extraskeletal Ewing sarcoma is a very rare form of malignant neoplasm. Only few cases have been reported on the literature. Here, we report a case of a 14-year-old boy who had a chief complaint of pain and tingling in the right lower limb. The patient initially seemed to have a giant nerve sheath tumor but was eventually diagnosed with intradural extraskeletal Ewing sarcoma arising from the nerve roots of the cauda equine. The literature with regard to primary spinal intradural extraskeletal Ewing sarcoma is reviewed.
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Affiliation(s)
- Mingfei Zhao
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang UniversityHangzhou, Zhejiang 310009, China
| | - Buyi Zhang
- Department of Pathology, Second Affiliated Hospital, School of Medicine, Zhejiang UniversityHangzhou, Zhejiang 310009, China
| | - Feng Liang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang UniversityHangzhou, Zhejiang 310009, China
| | - Jianmin Zhang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang UniversityHangzhou, Zhejiang 310009, China
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De Meis E, Brandão BC, Capella FC, Garcia JAP, Gregory SC. Catastrophic antiphospholipid syndrome in cancer patients: an Interaction of clotting, autoimmunity and tumor growth? Isr Med Assoc J 2014; 16:544-547. [PMID: 25351010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Thrombosis is a common phenomenon in patients with malignancies. It is believed that thrombosis is multifactorial and that in addition to mechanisms directly associated with cancer and its treatment, it may also be related to the interaction between the immune system and clotting. The present work describes four cancer patients (three adults and one child) whose clinical course was characteristic of catastrophic antiphospholipid syndrome (CAPS) in intensive care units of the National Cancer Institute of Rio de Janeiro. The presence of findings similar to those in CAPS can be attributed to an unbalanced interaction between the immune system and coagulation.
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26
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Mullera Martí M, Riba Solé M, Fernández de Gamarra Martínez E, Mangues Bafalluy MA. [Hypersensitivity reaction to etoposide. A case report]. Farm Hosp 2014; 38:255-256. [PMID: 24951914 DOI: 10.7399/fh.2014.38.3.702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- M Mullera Martí
- Servicio de Farmacia. Hospital de la Santa Creu i Sant Pau. Barcelona. España.
| | - M Riba Solé
- Servicio de Farmacia. Hospital de la Santa Creu i Sant Pau. Barcelona. España
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27
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Sasaki T, Onishi T, Yabana T, Hoshina A. Ewing's sarcoma/primitive neuroectodermal tumor arising from the adrenal gland: a case report and literature review. Tumori 2013. [PMID: 24158076 DOI: 10.1700/1334.14815] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We report a rare case of Ewing's sarcoma (ES)/primitive neuroectodermal tumor (PNET) arising from the adrenal gland. A 17-year-old Japanese woman presented with left upper abdominal pain and high fever. Computed tomography and magnetic resonance imaging revealed a 15 × 10 cm tumor replacing the adrenal gland. Preoperative diagnosis was an adrenocortical carcinoma. Resection of the tumor was performed. We obtained the final diagnosis of ES/PNET by immunohistochemical molecular study with positive staining for the MIC2 gene product (CD99) and a Ewing sarcoma breakpoint region 1 (EWSR1) gene rearrangement. Local recurrence was observed one month after the surgery. The patient was then treated with systemic chemotherapy and localized radiotherapy.
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MESH Headings
- 12E7 Antigen
- Abdominal Pain/etiology
- Adolescent
- Adrenal Gland Neoplasms/complications
- Adrenal Gland Neoplasms/diagnosis
- Adrenal Gland Neoplasms/genetics
- Adrenal Gland Neoplasms/therapy
- Antigens, CD/genetics
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Calmodulin-Binding Proteins/genetics
- Cell Adhesion Molecules/genetics
- Chemotherapy, Adjuvant
- Diagnosis, Differential
- Female
- Fever/etiology
- Gene Rearrangement
- Humans
- Immunohistochemistry
- Magnetic Resonance Imaging
- Neoplasm Recurrence, Local/diagnosis
- Neoplasm Recurrence, Local/therapy
- Neuroectodermal Tumors, Primitive, Peripheral/complications
- Neuroectodermal Tumors, Primitive, Peripheral/diagnosis
- Neuroectodermal Tumors, Primitive, Peripheral/therapy
- RNA-Binding Protein EWS
- RNA-Binding Proteins/genetics
- Radiotherapy, Adjuvant
- Sarcoma, Ewing/complications
- Sarcoma, Ewing/diagnosis
- Sarcoma, Ewing/genetics
- Sarcoma, Ewing/therapy
- Tomography, X-Ray Computed
- Treatment Outcome
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28
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Goozner M. A health plan that isn't worth keeping. Mod Healthc 2013; 43:22. [PMID: 24416869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Anderson RA, Hindmarsh PC, Wallace WHB. Induction of puberty by autograft of cryopreserved ovarian tissue in a patient previously treated for Ewing sarcoma. Eur J Cancer 2013; 49:2960-1. [PMID: 23731831 DOI: 10.1016/j.ejca.2013.04.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 04/03/2013] [Indexed: 11/19/2022]
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Vogin G, Helfre S, Glorion C, Mosseri V, Mascard E, Oberlin O, Gaspar N. Local control and sequelae in localised Ewing tumours of the spine: a French retrospective study. Eur J Cancer 2013; 49:1314-23. [PMID: 23402991 DOI: 10.1016/j.ejca.2012.12.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Revised: 11/23/2012] [Accepted: 12/05/2012] [Indexed: 12/23/2022]
Abstract
OBJECTIVES To evaluate both local outcome and sequelae of non-metastatic spinal Ewing tumours (EWT). PATIENTS AND METHODS A French cohort of patients ≤ 50years with localised spinal EWT treated between 1988 and 2009, was analysed in regard to tumour characteristics (e.g. volume, vertebral compartment, spinal cord compression, paraspinal soft tissue invasion), local treatment modalities (surgery (S) and margin quality, radiotherapy (RT) dose), response to treatment (e.g. histological response to neoadjuvant chemotherapy (CT)), tumour local control (LC) and sequelae. RESULTS Seventy-five patients treated in successive trials were evaluated for LC: SFOP-EW88 (n=14), SFOP-EW93 (n=17) and EuroEwing99 (n=44). Fifty-seven patients (79%) presented initial neurological compression and 69% had inaugural decompressive S. Local treatment modality was S+RT (n=50), RT alone (n=19) and S alone (n=6). Surgery was mainly intralesional (66%). Local recurrences had occurred in 19 patients (14 local, 5 loco-regional) with a median interval of 25 months (1-50). After a 7 year median follow-up (1-22 years), the 5-year LC, relapse-free survival (RFS) and overall survival (OS) reached 78.0% (95%CI: 62.6-84.6), 57.0% (95%CI: 45.2-68.9) and 70.0% (95%CI: 59.1-81.0), respectively. Vertebral compartment involved was the only prognostic factor (5-year LC rate 100% versus 71% for favourable and unfavourable compartment, p<0.03). Among 41 five-year survivors, we observed spinal curvature deformation (35%), growth retardation (28%), spinal reduction mobility (40%), spinal pain (25%) and neurological sequelae (32%) without any significant association with a particular local procedure. CONCLUSION RT is the backbone of a successful local treatment of spinal EWT. The place of S remains a pending question. Its actual benefit will likely evolve with new available RT techniques.
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Affiliation(s)
- Guillaume Vogin
- Département de Radiothérapie, Centre Alexis Vautrin, Nancy, France
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31
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Ernst E, Kjærsgaard M, Birkebæk NH, Clausen N, Andersen CY. Case report: stimulation of puberty in a girl with chemo- and radiation therapy induced ovarian failure by transplantation of a small part of her frozen/thawed ovarian tissue. Eur J Cancer 2012; 49:911-4. [PMID: 23084082 DOI: 10.1016/j.ejca.2012.09.028] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Accepted: 09/20/2012] [Indexed: 11/17/2022]
Abstract
AIM OF THE STUDY To induce puberty by transplantation of frozen/thawed ovarian tissue collected prior to gonadotoxic treatment for a cancer. PATIENTS AND METHODS A 9-year-old girl with Ewing sarcoma had one ovary excised and cryopreserved prior to chemo- and radiotherapy. Functional activity of the remaining ovary was destroyed during treatment. Four and a half years later the girl remained pre-pubertal with postmenopausal levels of FSH. Two of ten pieces of frozen/thawed cortex were transplanted to the remaining ovary in order to stimulate puberty. RESULTS Four months after the transplantation FSH returned to low levels. During the following year puberty gradually progressed to Tanner stage B4 and P3 and regular menstrual cycles started. However, after 19 months the function of the graft ceased. CONCLUSIONS We have shown for the first time in a girl treated for cancer that transplanted ovarian tissue can regain function and secrete estradiol in a sufficient amount to induce puberty. In addition, the majority of her ovarian tissue remains frozen with a possibility to support fertility in adult life.
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Affiliation(s)
- Erik Ernst
- Reproductive Laboratory, Institute of Anatomy, University of Aarhus and Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
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32
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Caselli D, Morfini M, Paolicchi O, Frenos S, Casini T, Aricò M. Cord blood hematopoietic stem cell transplantation in an adolescent with haemophilia. Haemophilia 2012; 18:e48-9. [PMID: 22226228 DOI: 10.1111/j.1365-2516.2011.02734.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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33
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Shnorhavorian M. A rewarding experience for a pediatric urologist. Cancer Treat Res 2010; 156:485. [PMID: 20811860 DOI: 10.1007/978-1-4419-6518-9_40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Margarett Shnorhavorian
- Department of Pediatric Urology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA, USA.
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Maheshwari AV, Shinault SS, Robinson PG, Pitcher JD. Cystic presentation of Ewing's sarcoma with indolent clinico-radiologic behaviour. Acta Orthop Belg 2009; 75:836-841. [PMID: 20166369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Ewing's sarcoma is a high-grade malignant primary bone tumour with aggressive clinico-radiologic features. Rarely, it exhibits a benign pattern, but presentation as a solitary bone cyst in a long bone is rather unusual. The purpose of this paper is to document such a cystic presentation with relatively benign clinico-radiologic course and to review the pertinent literature. A 27-year-old male presented with a pathologic fracture through a radiologically benign appearing solitary bone cyst in the distal tibial metaphysis. The fracture healed on conservative treatment, but the patient presented again a year later with pain and difficulty with weight bearing. Curetting and bone grafting done elsewhere was suggestive of an Ewing's sarcoma, which was later confirmed by a second biopsy. He was treated by standard neoadjuvant chemotherapy followed by wide local excision and reconstruction with an intercalary allograft. At 2 years postoperative follow-up, the patient is without any evidence of local or distant recurrence. Awareness of this atypical presentation is important because it may help in an earlier diagnosis, avoid diagnostic confusion and thus may contribute to improved survival.
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Affiliation(s)
- Aditya V Maheshwari
- Division of Musculoskeletal Oncology, Department of Orthopaedics, University of Miami Miller School of Medicine, Miami, FL, USA.
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35
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Choy E, Digumarthy SR, Koplin SA. Case records of the Massachusetts General Hospital. Case 36-2009. A 23-year-old man with cough, hoarseness, and abnormalities on chest imaging. N Engl J Med 2009; 361:2080-7. [PMID: 19923580 DOI: 10.1056/nejmcpc0907804] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Edwin Choy
- Division of Medical Oncology, Department of Medicine, Massachusetts General Hospital, USA
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36
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Abstract
In most pediatric tumors, particularly sarcomas, cyclophosphamide or ifosfamide represent essential first-line chemotherapeutic agents. Whereas cyclophosphamide is known to be associated with a well-defined cardiomyopathy, only a few cardiac complications following ifosfamide chemotherapy have been observed to date. Here we report a patient treated for Ewing sarcoma with multiple pulmonary and osseous metastases who repeatedly developed a supraventricular tachyarrhythmia following administration of ifosfamide as part of a polychemotherapy regimen.
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Affiliation(s)
- Lars Müller
- Department of Pediatric Hematology, Oncology and Immunology, University Medical Center, Heinrich-Heine-University, Düsseldorf, Germany
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37
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Pérez Marín JC, Apolinario Hidalgo RM, Mohamad Tubío AM, Santos Moyano Z, Peña Quintana P, Gómez Díaz J. [A 25-year-old man with pancreatic tumor, double vision and bone lesions]. Gastroenterol Hepatol 2008; 31:626-8. [PMID: 19091260 DOI: 10.1157/13128312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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38
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Jiménez Rodríguez RM, Díaz Pavón JM, Vázquez Monchul JM, Socas Macías M, Sánchez Gil JM. [Uncommon cause of abdominal pain: Ewing's sarcoma]. Rev Esp Enferm Dig 2007; 99:734-736. [PMID: 18290703 DOI: 10.4321/s1130-01082007001200015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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39
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Rodríguez-Galindo C, Liu T, Krasin MJ, Wu J, Billups CA, Daw NC, Spunt SL, Rao BN, Santana VM, Navid F. Analysis of prognostic factors in ewing sarcoma family of tumors: review of St. Jude Children's Research Hospital studies. Cancer 2007; 110:375-84. [PMID: 17569105 DOI: 10.1002/cncr.22821] [Citation(s) in RCA: 176] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Advances in systemic and local therapies have improved outcomes for patients with the Ewing sarcoma family of tumors (ESFT). As new treatments are developed, a critical review of data from past treatment eras is needed to identify clinically relevant risk groups. METHODS The authors reviewed the records of 220 patients with ESFT who were treated on protocols at St. Jude Children's Research Hospital from 1979 to 2004. Two treatment eras were defined. Factors predictive of outcome were analyzed to identify distinct risk groups. RESULTS The median age at diagnosis was 13.7 years (range, 1.1-25.2 years). Metastatic disease was associated with tumors measuring >8 cm (P = .002) and axial location (P = .014). The 5-year overall survival (OS) estimate (63.5% +/- 3.5%) did not appear to differ by protocol. Tumor stage and size were found to be the only independent predictors of outcome. Treatment era and type of local control therapy were found to influence the outcome of patients with localized disease. Four risk groups were defined: favorable risk (age <14 years with localized, nonpelvic tumors), intermediate risk (localized, age >/=14 years, or pelvic tumors), unfavorable-pulmonary (isolated lung metastases), and unfavorable-extrapulmonary (extrapulmonary metastases). The 5-year OS estimates for these groups were 88.1% +/- 4.4%, 64.9% +/- 5.2%, 53.8% +/- 9.4%, and 27.2% +/- 7.3%, respectively (P < .001). The incidence of therapy-related leukemia was significantly higher during the second treatment era, when more intensified regimens were used (6.1% +/- 2.7% vs 0% +/- 0%; P = .005). CONCLUSIONS Risk stratification schemes such as this should be used to prospectively evaluate novel risk-based therapies. Studies of biologic pathways may help to refine this model.
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40
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Kim DW, Chang HJ, Jeong JY, Lim SB, Lee JS, Hong EK, Lee GK, Choi HS, Jeong SY, Park JG. Ewing's sarcoma/primitive neuroectodermal tumor (ES/PNET) of the small bowel: a rare cause of intestinal obstruction. Int J Colorectal Dis 2007; 22:1137-8. [PMID: 16683104 DOI: 10.1007/s00384-006-0142-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2006] [Indexed: 02/04/2023]
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41
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Abstract
BACKGROUND Thromboembolism (TE) is a common complication and cause of death in adults with cancer. Cancer has been identified as a major risk factor in children with TE. However, the information regarding the epidemiology of TE in children with cancer, especially in association with childhood solid tumors, is scant. OBJECTIVE To define the prevalence and epidemiology of TE in children with sarcoma. PROCEDURE Hospital records of children </=18 years of age with sarcoma diagnosed and treated at McMaster Children's Hospital during January 1990 to December 2005 were reviewed for demographic details, details of diagnosis and therapy for sarcoma, and details of diagnosis and management of TE. Statistical analysis was performed using Fisher's exact t-test. RESULTS Ten of 70 (14.3%; 95% CI; 7.1, 24.7) patients with sarcoma developed symptomatic TE. Patients with CVL-dysfunction (n = 9) were at significantly higher risk for symptomatic TE compared to those without CVL dysfunction (n = 61) (55.5 vs. 8.2%; P = 0.002, 95% CI; 14.2, 80.5). Patients with pulmonary disease (n = 23) had higher prevalence of TE compared to those without pulmonary disease (n = 47) (26 vs.8.5%; P = 0.07, 95% CI; -2.06, 37.2). Older patients, patients with metastatic disease and those with Ewing sarcoma had higher prevalence of TE. CONCLUSIONS TE is a significant complication in children with sarcoma. Over 50% of patients with CVL dysfunction had symptomatic TE; such patients may warrant careful evaluation for associated TE. Large prospective studies are needed to define the epidemiology and identify risk factors predisposing to TE in children with sarcoma.
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Affiliation(s)
- Uma Athale
- Department of Pediatrics, Division of Hematology, McMaster University, Hamilton, Ontario, Canada.
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42
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Kier A, Timchur MD, McCarthy PW. A Case Report of an Uncommon Cause of Cauda Equina Symptoms. J Manipulative Physiol Ther 2007; 30:459-65. [PMID: 17693337 DOI: 10.1016/j.jmpt.2007.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2006] [Revised: 03/09/2007] [Accepted: 04/16/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This case report discusses a patient who presented with right-sided buttock pain of apparently uncomplicated mechanical origin that was eventually diagnosed as a primary Ewing sarcoma/primitive neuroectodermal tumor of the sacrum. CLINICAL FEATURES A 32-year-old male full-time student presented for care with right-sided buttock pain. INTERVENTION AND OUTCOME After examination, the patient was referred to his general practitioner for urgent magnetic resonance imaging, the report revealed no explanation for the presenting symptoms. After further imaging and biopsy, an eventual diagnosis of Ewing sarcoma/primitive neuroectodermal tumor was reached. The patient died 12 months later. CONCLUSION This case highlights a nondiscal cause for cauda equina symptoms. It emphasizes potential diagnostic complexities that may present due to preconceptions based upon the probability of symptoms being related to a specific disease process.
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Affiliation(s)
- Annabel Kier
- Welsh Institute of Chiropractic (WIOC), University of Glamorgan, Pontypridd, Wales, UK.
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43
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Steens SC, Kroon HM, Taminiau AH, De Schepper AM, Watt I. Nail-patella syndrome associated with Ewing sarcoma. JBR-BTR 2007; 90:214-5. [PMID: 17696103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- S C Steens
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
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44
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Fajardo Olivares M, Garduño Eseverri E, Pintor Trevejo I, Vagace Valero JM. [Infection caused by Fusarium species in non-neutropenic oncological patients]. An Pediatr (Barc) 2007; 66:194-5. [PMID: 17306111 DOI: 10.1016/s1695-4033(07)70334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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45
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Moustafellos P, Gourgiotis S, Athanasopoulos G, Karagianni E, Hadjiyannakis E. A spontaneously ruptured primitive neuroectodermal tumor/extraosseous Ewing's sarcoma of the kidney with renal vein tumor thrombus. Int Urol Nephrol 2007; 39:393-5. [PMID: 17310314 DOI: 10.1007/s11255-006-9073-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Accepted: 06/20/2006] [Indexed: 10/23/2022]
Abstract
Primitive neuroectodermal tumor/extraosseous Ewing's sarcoma (PNET/EES) is a childhood disease rarely seen in adults. It is a soft tissue tumor, which is often observed in the paraspinal region and lower extremity. We report the case of a 32-year-old man who presented with sudden abdominal pain on the right upper quadrant that was radiated to the right flank. During the operation, a spontaneously ruptured right kidney mass was found. The histopathologic and immunohistochemical characteristics of the excised mass were consistent with PNET/EES. This is the first known reported case of spontaneously ruptured PNET/EES of the kidney with renal vein tumor thrombus. The clinical details and the management of this case are described.
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46
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Abstract
PURPOSE To identify predisposing factors, radiologic features, and clinical outcome of posterior reversible leucoencephalopathy (PRES) in children receiving cancer treatment. METHODS We identified 11 patients (7 female) who had radiological and clinical features consistent with PRES and were treated for cancer at St. Jude Children's Research Hospital between January 1995 and January 2005. Clinical and radiographic data were abstracted from their records. RESULTS The average age at the time of PRES onset was 10.4 years. Primary diagnoses were acute leukemia (n = 8), non-Hodgkin lymphoma (n = 2), and Ewing sarcoma (n = 1). PRES occurred in 8 patients during the induction phase of treatment, and all 11 patients had hypertension (5 chronically). Seizure activity was proximate to cytarabine and tacrolimus administration in three patients and further seizures occurred with re-administration of these medications in two patients. Coagulation and chemistry studies were normal. Concurrent brain magnetic resonance imaging (MRI) demonstrated T2 signal abnormalities in all 11 patients, restricted diffusion in 4, and hemorrhage in 3. Follow-up MRI showed chronic changes consistent with a previous hemorrhage in three and evidence of prior parenchymal ischemia in one. Three patients developed epilepsy and remain on chronic anticonvulsant therapy. CONCLUSIONS PRES is an increasingly recognized complication of pediatric cancer treatment. Risk factors for PRES in pediatric cancer patients include hypertension (not necessarily acute), remission induction chemotherapy, and administration of tacrolimus. MR images often show atypical findings, some of which are irreversible. A significant number of patients develop epilepsy despite clinical and radiographic evidence of recovery.
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Affiliation(s)
- E Brannon Morris
- Division of Neurology, St. Jude Children's Research Hospital, Memphis, Tennessee 38105, USA.
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47
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Affiliation(s)
- Gokhan Bozkurt
- Institute of Neurological Sciences and Psychiatry, Hacettepe University School of Medicine, Ankara, Turkey.
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48
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Jackson WFM, Theologis TN, Gibbons CLMH, Mathews S, Kambouroglou G. Early management of pathological fractures in children. Injury 2007; 38:194-200. [PMID: 17054958 DOI: 10.1016/j.injury.2006.07.040] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 07/19/2006] [Accepted: 07/26/2006] [Indexed: 02/02/2023]
Abstract
The management of pathological fractures in children remains controversial. The indications for surgical treatment are unclear and the need for histological diagnosis before or after definitive treatment is not clearly defined. We reviewed retrospectively the records of all patients under the age of 16 years who presented over the past 7 years with a fracture as the first manifestation of bone pathology. There were 23 patients (16 boys and 7 girls) of an average age of 12 years and 2 months (range 4.1-15.8 years). There were nine cases of fracture through a simple bone cyst, five cases of fibrous dysplasia, two giant cell tumours, three aneurysmal bone cysts, one chondroblastoma, and three cases of Ewings sarcoma. After review of our cases we propose a simple algorithm for the safe early management and assessment of paediatric pathological fractures. We recommend that primary fixation of pathological fractures should be avoided until histological diagnosis is obtained. Most lesions should eventually be biopsied. However, if radiographic appearances are reassuringly benign, biopsy can be delayed until conservative fracture management is completed. Definitive treatment of benign lesions with protective intra medullary nailing or curettage and grafting can follow frozen section under the same anaesthetic.
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Affiliation(s)
- W F M Jackson
- Nuffield Orthopaedic Centre, Department of Orthopaedics, Windmill Road, Headington, Oxford, UK.
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49
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Finstein JL, Fox EJ, Chin K, Alvandi F. Abdominal pain in a 71-year-old woman. Clin Orthop Relat Res 2006; 453:341-7. [PMID: 16906066 DOI: 10.1097/01.blo.0000229327.60664.9d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- Joseph L Finstein
- Department of Orthopaedic Surgery, University of Pennsylvania, PA, USA
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50
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Rzyman W, Tønnessen T. Fulminant thoracic sarcoma masked by hemothorax. J Thorac Oncol 2006; 1:856. [PMID: 17409970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Affiliation(s)
- Witold Rzyman
- Department of Thoracic Surgery, Heart and Lung Center of Ullevaal University Hospital, Oslo, Norway.
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