Haemoptysis in Askin's Tumour: Intrapulmonary Presentation of an Extrapulmonary Tumour

Ewing's sarcoma (ES) is a small round cell sarcoma arising in the bone or soft tissue. Ewing's sarcoma/primitive neuroectodermal tumours (PNET) of the thoracopulmonary region is called Askin's tumour. The common clinical presentations described for this extrapulmonary tumour are fever, chest wall mass with or without pain, dyspnea, and cough. Very few cases of Askin's tumour have been reported with haemoptysis as the initial presentation, which is usually a presentation of intrapulmonary lesions. A 22-year-old male presented to the emergency department with complaints of haemoptysis, mild chest pain, and swelling on the right side of the chest wall. Radiological investigations showed a soft tissue mass measuring 13 cm × 11 cm × 10 cm in the right thoracic region, causing the destruction of the second rib. Histopathological examination showed the presence of a malignant small round cell tumour. Immunohistochemistry (IHC) analysis showed the tumour to be positive for CD99, NKX 2.2, and MIC2. The final diagnosis of Askin's tumour of the thoracopulmonary region was given. The case is being reported in view of the rare type of clinical presentation.