Ewing’s sarcoma

by

Ewing’s sarcoma

Ewing’s sarcoma: aggressive malignant tumor with a peak incidence during the second decade of life. Spine metastases are more common than primary spine lesions.

Treatment

Treatment is mostly palliative: radical excision followed by RTX (very radiosensitive) and chemotherapy 1).

The use of stereotactic body radiotherapy (SBRT) is well-accepted 2).

SRS for spine metastases from Ewing sarcoma can be considered as a treatment option in adolescent and young adult patients and is associated with acceptable toxicity rates. Further studies must be conducted to determine long-term local control and toxicity for this treatment modality 3).

Complications

SIADH.

Combined intracranial/extracranial lesions.

see Ewing’s Sarcoma peripheral primitive neuroectodermal tumor

Case reports

Intradural Extramedullary Ewing’s Sarcoma in the Cervical Region 4).

A 21-year-old woman presenting with quadriplegia which was initially diagnosed with an epidural abscess in view of her MR scan and raised inflammatory marker levels. Histology revealed an epidural extra-osseous Ewing’s sarcoma (EES). Epidural location of EES is a very rare condition which can be very challenging to diagnose. Early diagnosis and surgical excision followed by chemotherapy represent the main stem of management 5).

References

1)

Grubb MR, Currier BL, Pritchard DJ, et al. Primary Ewing’s Sarcoma of the Spine. Spine. 1994; 19:309– 313
2)

Karimi AM, Campbell SR, Parsai S, Angelov L, Scott J, Qi P, Anderson P, Chao ST, Murphy ES. Aggressive Local Control With Multisite Stereotactic Body Radiation in Metastatic Ewing Sarcoma: A Literature Review and Case Report. Anticancer Res. 2020 Feb;40(2):951-955. doi: 10.21873/anticanres.14028. Review. PubMed PMID: 32014939.
3)

Parsai S, Juloori A, Angelov L, Scott JG, Krishnaney AA, Udo-Inyang I, Zhuang T, Qi P, Kolar M, Anderson P, Zahler S, Chao ST, Suh JH, Murphy ES. Spine radiosurgery in adolescents and young adults: early outcomes and toxicity in patients with metastatic Ewing sarcoma and osteosarcoma. J Neurosurg Spine. 2019 Nov 29:1-8. doi: 10.3171/2019.9.SPINE19377. [Epub ahead of print] PubMed PMID: 31783349.
4)

Warade AC, Jha AK, Pattankar S, Madiwale C, Rekhi B, Desai K. A Rare Case of Intradural Extramedullary Ewing’s Sarcoma in the Cervical Region. Neurol India. 2019 Nov-Dec;67(6):1543-1544. doi: 10.4103/0028-3886.273622. PubMed PMID: 31857557.
5)

Bailey M, Mccabe M, Pal P, Agushi E, Karabatsou K. Cervical epidural extra-osseous Ewing sarcoma mimicking an epidural abscess. Br J Neurosurg. 2016 Feb;30(1):113-114. Epub 2015 Sep 7. PubMed PMID: 26982951.

Leave a Reply