Clinicodemographic characteristics of extraosseous ewing sarcoma: A comparative meta-analysis of pediatric and adult patients

Background

Evidence suggests different presentation patterns and prognosis of extraosseous Ewing Sarcoma (EES) based on age. Thus, we carried out this study to test the difference between children and adult EES cases regarding clinicodemographic characteristics and prognosis.

Methods

A total of 4 databases were explored yielding 18 relevant studies for data synthesis. Outcomes included the comparison of demographic and clinical characteristics as well as prognosis between children and adults with EES. Log odds ratio (logOR) and its 95% confidence interval (CI) were pooled across studies. Statistical models/methods were selected based on heterogeneity.

Results

Our analysis included a total of 1261 children and 1256 adults. When we compared these two age categories, we did not observe a significant difference in the risk of developing EES [logOR = -0.13; 95% CI: -0.65: 0.39; I2 = 88.42%]. No significant differences regarding gender, tumor location, and size (≤5 vs. >5 cm), EWSR1 positivity, or management modality. We did not observe significant difference regarding clinical outcomes, such as 5-year overall survival and event-free survival, recurrence, mortality, no evidence of disease, and secondary metastasis.

Conclusions

Our findings highlight the absence of an association between the age category of patients and the incidence of EES, as well as its clinical outcomes.

A Pediatric Floating Elbow Associating Flexion Type Supracondylar Fracture with Both Bone Forearm Fracture And Ulnar Nerve Irritation: A Case Report

Introduction:

Pediatric floating elbow in the setting of flexion type-supracondylar fracture is exceptional. Most reported cases in the literature include the more common variant of supracondylar fracture which is the extension type. We report a rare case of pediatric floating elbow associating flexion type supracondylar fracture with both bone forearm fracture and ulnar nerve irritation.

Case Report:

A 5-year-old boy presenting to the emergency department after sustaining a fall from 3 m height. At presentation, he had an S-shaped deformity of the left upper limb, along with ecchymosis of the medial side of the elbow and the anterior aspect of the forearm. He was also complaining of severe pain with numbness in the territories of the ulnar nerve at the level of the wrist and hand without any signs of the median nerve or radial nerve neuropraxia or injury. The primary assessment demonstrated left flexion type supracondylar fracture, along with ipsilateral radial shaft fracture and ulnar shaft fracture. The patient was treated surgically by open reduction internal fixation of the supracondylar fracture followed by closed reduction and fixation of both bone forearm fracture.

Conclusion:

This case is reported for the unique association of flexion type supracondylar fracture – a rare type of supracondylar fracture in children – with ipsilateral both bone forearm fracture in a setting of the floating elbow and a relatively low incident complication which is ulnar nerve neuropraxia.