Case of the Month
Section Editor: Nicholas Stence, MD
Children's Hospital Colorado, Aurora, CO
SEPTEMBER 2012
Next Case of the Month coming October 2...
Ewing’s Sarcoma
- Background:
- Ewing’s sarcoma is the second most common bone tumor in children and young adults, with 90% of cases occurring in patients under 20.
- It can occur in any bone, but is most commonly found in the lower extremities.
- Extraosseous tumors can present, but are rare.
- Clinical Presentation:
- Patients usually present with localized pain and swelling.
- A soft tissue mass is sometimes palpable.
- Systemic symptoms such as fever, fatigue, or anemia are less common.
- Key Diagnostic Features:
- Predominantly lytic lesions involving vertebral body on CT
- Heterogeneous contrast enhancement with areas of necrosis on T1 MRI
- Suggestive age group
- Histological and genetic confirmation; t(11,22)(q24;q12) translocation found in 95% of cases
- Differential Diagnoses:
- Peripheral primitive neuroectodermal tumor
- Langerhan’s cell histiocytosis
- Lymphoma or leukemia
- Osteosarcoma
- Osteomyelitis
- Treatment:
- Systemic chemotherapy followed by local treatment (surgical resection or radiotherapy)
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