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Extraskeletal presentation of Ewing's Sarcoma
Danny Mangual1, Luis A Bisbal-Matos1, Ricardo Jiménez-Lee2
1Student, Department of Surgery, University of Puerto Rico Medical Sciences Campus, San Juan, PR.
Puerto Rico Health Sciences Journal
|March 17, 2018
Summary
A rare Ewing's sarcoma case in an adult female, initially misdiagnosed as synovial sarcoma, highlights the importance of accurate diagnosis and multimodal treatment for successful outcomes in complex bone and soft tissue tumors.
Area of Science:
- Oncology
- Surgical Pathology
- Radiology
Background:
- A 27-year-old female presented with an occipito-parietal mass following trauma.
- Initial biopsy suggested synovial sarcoma, leading to surgical excision and pericranial flap reconstruction.
Observation:
- Recurrence revealed a small-cell sarcoma, consistent with Ewing's sarcoma, involving the parietal sagittal sinus.
- The patient underwent neoadjuvant and adjuvant chemotherapy, including doxorubicin, vincristine, cyclophosphamide, etoposide, and ifosfamide.
Findings:
- A second wide excision was performed, followed by reconstruction with skin substitutes and grafts.
- Post-treatment PET scans indicated no evidence of disease recurrence in soft tissues or skeletal structures.
Implications:
- This case underscores the diagnostic challenges in soft tissue sarcomas and the efficacy of aggressive, multimodal treatment strategies.
- Complete remission after 2 years suggests favorable prognosis with timely and comprehensive management of Ewing's sarcoma, even in atypical presentations.
