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Extra-skeletal Ewing's sarcoma resembling acute abdomen. Case report
Gilberto Guzmán Valdivia Gómez1, María Teresa Soto Guerrero, María Isabel Cedillo de la Cruz
1Departamento de Cirugía General, Hospital General Regional 1 Gabriel Mancera, Instituto Mexicano del Seguro Social, México, DF, Mexico. guzvaldi@yahoo.com
Cirugia Y Cirujanos
|May 19, 2010
Summary
Extraosseous Ewing's sarcoma rarely presents as acute abdomen. Surgical resection is key for this rare neuroectodermal tumor, with chemotherapy and biopsy aiding prognosis.
Area of Science:
- Oncology
- Surgical Pathology
- Medical Imaging
Background:
- Extraosseous Ewing's sarcoma (EES) is a rare neuroectodermal tumor.
- Typically found in soft tissues of extremities and thorax.
- Histologically similar to bone-based Ewing's sarcoma.
Observation:
- A male patient presented with acute abdomen, leukocytosis, and imaging suggestive of complicated diverticular disease.
- Emergency surgery revealed an unsuspected 20x15x15 cm tumor.
- Initial treatment included tumor extirpation and six cycles of epirubicin, cyclophosphamide, and vincristine chemotherapy.
Findings:
- Post-operative CT showed residual tumor activity in the retroperitoneum.
- Further resection was performed due to tumor recurrence.
- Literature review found no prior reports of EES presenting as acute abdomen.
Implications:
- This case highlights EES as a rare cause of acute abdomen.
- Surgery is the primary treatment; preoperative chemotherapy is not standard.
- Percutaneous needle biopsy is crucial for diagnosis and treatment planning when feasible.
