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Massive FungatingEwing's Sarcoma of Scapula Treated by Limb Salvage Surgery: A Case Report
Pramod Chinder1, Suraj Hindiskere1,2, Srinath Doddarangappa1
1Department of Musculoskeletal Oncology, HCG Hospital, Bengaluru, India.
Introduction:
Ewing's sarcoma (ES) is a malignant tumor of the bone and soft tissue arising from the neuroectodermal cells. It commonly arises from the extremities of children and young adults and very rarely from flat bones like the scapula. Locally advanced disease with prior history of surgery and poor response to neoadjuvant chemotherapy in a bedridden patient is usually treated by forequarter amputation, considering the anatomical complexity of the shoulder girdle.
Case Report:
A young adult diagnosed and previously operated for ES of the left scapula, presented to us with a massive fun gating mass over the left upper back, excruciating pain and inability to use the left upper limb. Limb salvage surgery was performed, followed by adjuvant radiotherapy, chemotherapy, and autologous stem-cell transplantation. The patient is disease free with a functional limb on 3 years of follow-up.
Conclusion:
ES of scapula is very rare. With meticulous surgery and multidisciplinary treatment approach, limb salvage can be achieved even in such advanced cases, thereby prolonging survival and providing better quality of life.