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Updated: Jun 3, 2026

Intraoperative Ultrasound in Spinal Surgery

Intraoperative Ultrasound in Spinal Surgery

Published on: August 17, 2022

Spinal intradural extraosseous Ewing's sarcoma.

Farrah J Mateen¹, Aziza Nassar, Aditya Bardia

¹Department of Neurology, Johns Hopkins Hospital, Baltimore, MD;

|April 6, 2011

Summary

This summary is machine-generated.

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Extraosseous Ewing's sarcoma (EES) can occur in the central nervous system, even in older adults. Early diagnosis via molecular markers and multimodal therapy can lead to favorable outcomes for spinal EES.

Area of Science:

Neuro-oncology
Molecular diagnostics
Skeletal and soft tissue sarcomas

Background:

Extraosseous Ewing's sarcoma (EES) is a rare malignancy typically affecting children and young adults.
Central nervous system involvement by EES is exceptionally uncommon.
Distinguishing EES from other primitive neuroectodermal tumors (PNET) relies on identifying the characteristic (11;22) chromosomal translocation.

Observation:

This report details two cases of EES originating in the spinal intradural extramedullary space in men aged 50 and 60.
Diagnostic methods included imaging, histopathology, and molecular analysis, confirming the FL1-EWS fusion product via RT-PCR.
Literature review from 1970-2009 identified similar rare occurrences of EES in the central nervous system.

Findings:

Keywords:

extraosseous ewing's sarcoma intradural meninges.spinal cord

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Multimodal therapy, combining surgery, radiation, and alternating chemotherapy (vincristine, cyclophosphamide, doxorubicin, ifosfamide, etoposide), achieved local tumor control.

Both patients demonstrated an initial favorable therapeutic response with no evidence of systemic disease during follow-up (26 months) or at the time of death (4 years).

The findings challenge the perception of EES being exclusively a disease of early life.

Implications:

Extraosseous Ewing's sarcoma can present as an intradural spinal mass without systemic involvement, even in older individuals.
Gross total resection followed by multimodal therapy may improve progression-free and overall survival for spinal EES.
This case series expands the understanding of EES presentation and treatment possibilities within the central nervous system.