One-stage combined approach en bloc vertebrectomy for primary Ewing’s sarcoma of mobile spine in an adult patient: 3 years following agressive surgery for a rare entity

Gharbi, Mohamed Amine; Chahed, Houssem Eddine; Slama, Sana Ben; Tebourbi, Anis; Bouzidi, Ramzi; Nefiss, Mouadh

doi:10.22541/au.167697365.57119216/v1

Cited by 1 publication

(2 citation statements)

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“…In T2-sequences, the tumor shows hyperintensity, and in T1 an isointense signal. Diffusion-weighted images (DWI) also provide good information, showing limited diffusion with a low value of the apparent diffusion coefficient [ 3 , 7 , 9 ]. In addition to the performed imaging studies of the spine, the native CT scan of the lung was also taken into account, where in our case a lesion located on the left in the area of the 6th rib, along the middle axillary line, a soft tissue tumor formation, with destruction of the adjacent rib, was visualized which is assumed to be metastatic.…”

Section: Discussionmentioning

confidence: 99%

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Unusual Presentation of Thoracic Epidural Ewing Sarcoma in a 20-Year-Old Patient: A Case Report

Markov,

Bechev,

Markov

et al. 2024

Cureus

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The aim of this case report is to present a rare case of epidural Ewing sarcoma with spinal cord compression, which is an uncommon presentation of this tumor. Ewing's sarcoma is a primary malignant tumor predominantly affecting individuals in their second decade of life, primarily impacting those aged 10 to 25, with the average age of onset being around 20 years. Epidemiological studies reveal that this cancer most commonly arises in the diaphyses of the long tubular bones in the lower extremities. Spinal involvement, however, is exceedingly uncommon. A case of sacral type of Ewing's sarcoma, with the most common localization of the primary spinal sarcomas and an extremely aggressive course, has been described in the literature. Other localizations of Ewing's sarcoma located in other areas of the spine are also presented. Even rarer are cases in which the tumor formation is located epidurally and exhibits marked medullary compression and absent neurological symptoms. We present the case of a 20-year-old patient who was admitted to the neurology department with symptoms of lower flaccid paraparesis and pelvic-reservoir dysfunction, specifically urinary retention for 16-17 hours, after which a catheter was added. MRI revealed an epidural tumor spanning TH5-TH7 vertebral levels, causing significant spinal cord compression. A CT scan of the chest identified a tumor on the left side at the level of the sixth rib, featuring soft tissue involvement, rib destruction, lung invasion, and a small pleural effusion. Due to the critical neurological symptoms, the patient underwent emergency surgery in the neurosurgical department, which included thoracic laminectomies, maximal possible tumor resection, and effective spinal cord decompression. Postoperative period was uneventful. Histopathological examination confirmed the diagnosis of Ewing's epidural sarcoma. The patient subsequently received adjuvant chemotherapy and radiotherapy. Six months post-treatment, the patient demonstrated a satisfactory overall condition with significant improvement in gait and continues to undergo chemotherapy courses.

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Section: Discussionmentioning

confidence: 99%

“…Primary ESs are considered histologically as undifferentiated small-cell tumors [ 2 ]. Literature data indicate a prevalence of 3.5-14.9% spinal involvement from all other locations [ 3 ].…”

Section: Introductionmentioning

confidence: 99%