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Thoracoscopic (hybrid) complex chest wall resection in pediatric Ewing sarcoma
Anish Pranav Sampath Kumar1, Suhaildeen Kajamohideen2, Balasubramanian Venkitaraman2
1Department of General Surgery, Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
Insights
Askin tumor, a rare Ewing sarcoma variant, commonly affects pediatric chest walls. Complete surgical resection, even with complex intraspinal extension, is crucial for effective management.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Spinal Surgery
Background:
- Askin tumor, a variant of Ewing sarcoma, is the most frequent pediatric chest wall neoplasm.
- Complete surgical resection is the primary treatment modality for effective management.
- Multimodal treatment approaches are typically necessary.
Observation:
- A 13-year-old male presented with a left paraspinal Askin tumor.
- The tumor exhibited intraspinal extension, causing spinal cord compression and neurological deficits.
- The patient received neoadjuvant therapy prior to surgical intervention.
Findings:
- A complex surgical resection was performed, involving thoracoscopic removal of multiple ribs.
- Vertebral resection and subsequent reconstruction were integral parts of the surgical procedure.
- Successful resection was achieved following neoadjuvant therapy.
Implications:
- This case highlights the feasibility of complex surgical resection for pediatric chest wall Askin tumors with intraspinal extension.
- Advanced surgical techniques, including thoracoscopic approaches and vertebral reconstruction, can achieve complete tumor removal.
- Effective management necessitates a multidisciplinary approach integrating neoadjuvant therapy and complex surgical resection.
Abstract:
Askin tumor (a Ewing sarcoma variant) is the most common tumor of the chest wall in the pediatric age group. Multimodal treatment is required, with complete resection being the cornerstone of effective management. We describe the case of a 13-year boy with a left paraspinal Ewing sarcoma with intraspinal extension and spinal cord compression with neurological weakness. He underwent complex surgical resection using thoracoscopic resection of multiple ribs along with vertebral resection and reconstruction, after neoadjuvant therapy.
