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Isolated delayed metastasis to the talus from Ewing's sarcoma
Layla Nasr1, Lena Naffaa1, Alaeddine El Alayli1
1Department Of Radiology, American University Of Beirut Medical Center, Beirut, Lebanon.
Journal of Radiology Case Reports
|January 18, 2019
Summary
Acrometastasis, or bone metastasis to extremities, is rare. This case highlights an isolated talar metastasis from Ewing's sarcoma 7 years post-remission, mimicking a benign lesion.
Area of Science:
- Oncology
- Radiology
- Orthopedic Oncology
Background:
- Acrometastasis (bone metastasis to hands and feet) is exceptionally rare and typically indicates widespread disease.
- Ewing's sarcoma is a rare malignant bone tumor predominantly affecting children and young adults.
Observation:
- A 14-year-old female with a history of treated rib Ewing's sarcoma presented with an isolated lesion in the talus.
- Imaging studies including MRI, CT, and PET-CT were performed to characterize the lesion.
- The lesion's imaging characteristics, particularly on CT, were suggestive of a benign process.
Findings:
- Pathological confirmation revealed an isolated metastatic lesion to the talus, 7 years after achieving remission from primary Ewing's sarcoma.
- This represents a rare instance of isolated acrometastasis from Ewing's sarcoma, with only two prior reports in English literature.
- One prior case involved skip metastasis, and the other lacked detailed description of tumor characteristics.
Implications:
- This case underscores the importance of considering metastatic disease even in isolated bone lesions presenting years after remission.
- The potential for acrometastasis from Ewing's sarcoma, even as an isolated finding, requires careful diagnostic consideration.
- Advanced imaging modalities are crucial for differentiating benign-appearing metastatic lesions from primary bone tumors or other pathologies.
