Related Experiment Video
Updated: May 12, 2026
04:04
Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Pulmonary coccidiomycosis masquerading as refractory metastatic Ewing sarcoma
Elliot Stieglitz1, Michelle S Hsiang, Jeffry P Simko
1*Department of Pediatric Hematology Oncology, UCSF Benioff Children's Hospital †Department of Anatomic Pathology, Urology and Radiation Oncology, UCSF, San Francisco, CA.
Journal of Pediatric Hematology/Oncology
|April 17, 2013
Summary
A patient with Ewing sarcoma and presumed metastatic lung disease showed a mixed response to chemotherapy. Surgical removal of a growing lesion revealed it was Coccidioides immitis, not sarcoma metastasis.
Area of Science:
- Oncology
- Infectious Diseases
- Radiology
Background:
- A patient presented with a large pelvic mass diagnosed as Ewing sarcoma.
- Staging computed tomography (CT) revealed 18 pulmonary lesions, presumed to be metastatic disease.
Observation:
- Following induction chemotherapy, positron emission tomography/CT (PET/CT) demonstrated significant reduction in the pelvic mass.
- Most pulmonary lesions improved, but two lesions increased in size, indicating an unusual mixed response.
Findings:
- Surgical resection of a growing pulmonary lesion was performed.
- Fungal cultures from the excised lesion identified Coccidioides immitis.
Implications:
- This case highlights the importance of considering infectious etiologies, such as Coccidioides immitis, in patients with suspected metastatic cancer.
- It underscores the need for thorough diagnostic evaluation when faced with atypical treatment responses in oncology.
- Differential diagnosis between malignancy and infection is critical for appropriate patient management.
Related Concept Videos
01:31Pulmonary Tuberculosis III
Tuberculosis (TB) is a contagious infection primarily affecting the lung parenchyma but which can also affect other body parts. TB can be classified based on disease development, presentation, and the affected anatomical site.
The first classification is based on the development of the disease, and it includes the following categories:
The first classification is based on the development of the disease, and it includes the following categories:
02:30Metastasis
Metastasis is the spread of cancer cells from the original site to distant locations in the body. Cancer cells can spread via blood vessels (hematogenous) as well as lymph vessels in the body.
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...