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Extraskeletal Ewing sarcoma of the sciatic nerve.

Daniel Heller¹, Gabrielle Wasilewski¹, Jabra Mustafa¹

¹Loyola University Chicago and Loyola University Medical Center, 2160 S 1st Ave, Maywood, IL 60153, USA.

Radiology Case Reports

|January 20, 2023

Summary

Extraskeletal Ewing sarcoma (EES) is a rare cancer, typically seen in younger individuals. This case highlights a rare sciatic nerve EES in a 60-year-old, challenging typical diagnostic assumptions.

Keywords:

EES, extraskeletal Ewing sarcoma EFT, Ewing family of tumors EWSR1, Ewing sarcoma RNA binding protein 1 Ewing sarcoma Extraosseous Ewing sarcoma Extraskeletal Ewing sarcoma FISH, fluorescent in situ hybridization LCA, leukocyte common antigen PNET, primitive neuroectodermal tumor Sciatic nerve

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Area of Science:

Oncology
Pathology
Radiology

Background:

Extraskeletal Ewing sarcoma (EES) is a rare malignant neoplasm predominantly affecting pediatric and young adult populations.
EES presents diagnostic and therapeutic challenges due to its rarity and often low index of suspicion.
The occurrence of EES in individuals over 30 years old is exceptionally uncommon.

Observation:

A 60-year-old male presented with a sciatic nerve tumor.
Initial imaging suggested a potential nerve sheath tumor.
The tumor was ultimately diagnosed as Extraskeletal Ewing sarcoma.

Findings:

The patient's age (60 years) is atypical for EES.
The sciatic nerve is an unusual location for EES.
The imaging characteristics mimicked those of a nerve sheath tumor, complicating the diagnosis.

Implications:

This case underscores the importance of considering rare diagnoses in atypical patient demographics.
Highlights the need for advanced diagnostic modalities when EES is suspected in older adults.
Broadens the understanding of EES presentation, location, and potential imaging mimicry.