Peripheral neuroectodermal tumour of the kidney (Ewing’s sarcoma): Restaging with 18F-fluorodeoxyglucose (FDG)-PET/CT

Öztürk, Hakan

doi:10.5489/cuaj.2286

CUAJ

2015

DOI: 10.5489/cuaj.2286

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Peripheral neuroectodermal tumour of the kidney (Ewing’s sarcoma): Restaging with 18F-fluorodeoxyglucose (FDG)-PET/CT

Hakan Öztürk¹

Abstract: Primitive peripheral neuroectodermal tumour and Ewing's sarcoma (PNET/EWS) were originally described as two distinct pathologic entities, although both share common stem-cell precursor and unique chromosomal abnormality. Although its incidence has increased recently, its share in all sarcomas is 1%. It is usually seen in men and women in their twenties. We present a case of a 38-year-old woman with a left renal mass detected incidentally. Magnetic resonance imaging revealed a centrally located hypervascular re… Show more

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Cited by 3 publications

References 29 publications

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Primary Ewing sarcoma of the kidney

et al. 2019

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Primary Ewing sarcoma (ES) or primitive neuroectodermal tumour (PNET) is a rare tumour in adults and primary renal involvement is extremely rare. Patients with renal ES or PNET respond to and would benefit from conventional ES treatment according to ES study protocols. Here, we report a case of a young woman, presenting with right flank pain and haematuria. After ultrasound and CT evaluation, a right middle pole renal mass was detected. The patient underwent radical right nephrectomy, and a grade 4 ES with peritoneal involvement was documented. Subsequently, the patient underwent adjuvant chemotherapy for 5 months. Follow-up 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scan demonstrated bilateral cervical, hilar, mediastinal and retroperitoneal FDG-avid adenopathies associated with mild right-sided pleural effusion with no metabolic activity, signifying the role of PET/CT scan in tumour restaging.

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Primary Ewing sarcoma of the kidney

et al. 2019

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Ewing’s sarcoma of the right kidney with multiple metastasis on PET/CT

Singh

Verma

Kakkar

et al. 2023

Egypt J Radiol Nucl Med

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Background Ewing’s sarcoma is categorized as small round cell aggressive tumor which commonly occurs in bone and soft tissue. Primary renal Ewing’s sarcoma is an extremely rare entity and accounts for less than 1% of renal masses. It is characterized by a very aggressive course, with very few reported cases in the literature. Primary renal Ewing’s sarcoma is indistinguishable from renal cell carcinoma on anatomical imaging and therefore need histopathological correlation for confirmation. The positron emission tomography (PET) fused with computed tomography (CT) helps in the evaluation of disease, for staging and metastatic workup. Case presentation We present a case of 48-year-old lady who presented to urology department with difficulty in passing urine for 5 months associated with pain in the right flank region. She had an episode of haematuria 5 months back. Contrast enhanced CT showed a large lobulated heterogeneously enhancing right retroperitoneal mass in renal fossa. Histopathological examination and immunohistochemistry were suggestive of Ewing’s sarcoma. The PET/CT revealed FDG avid right renal mass with lymph nodal and skeletal metastasis. Conclusions Ewing’s sarcoma being aggressive tumour usually present with bone, liver and lung metastasis along with lymph nodal metastasis at time of diagnosis. The 18 F FDG PET/CT helps in diagnosis, staging, appropriate treatment planning, restaging, response evaluation and prognostication of Ewing’s sarcoma.

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Primary pancreatic Ewing sarcoma with metastases on FDG PET/CT

Singh,

Verma,

Kakkar

et al. 2023

Egypt J Radiol Nucl Med

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Background Ewing sarcoma (ES) is a highly aggressive malignant tumor most commonly affecting long bones. Extraskeletal Ewing sarcoma (EES) is a malignant tumor with aggressive behavior carrying bad prognosis with pancreas being an extremely rare primary site. We present a case of histopathologically proven EES of the pancreas in a young female who presented with abdominal pain. 18F-fluorodeoxyglucose positron emission tomography (18F FDG PET/CT) is a useful modality for detecting distant metastases in EES. It helps in diagnosis, localizing the primary, its extension, optimal treatment planning and evaluation of response to standard treatments available. Case presentation An 18-year-old female presented with complaints of progressive abdominal pain and distention since 6 weeks. Physical examination was suggestive of a solid large mass in the upper left abdomen and decreased breath sounds with dullness in the left lower lung fields. On Contrast enhanced computed tomography (CECT) imaging, a large heterogeneously enhancing mass was seen arising from pancreas along with retroperitoneal lymphadenopathy. A moderate sized left sided pleural effusion with atelectasis of lower lobe of left lung was also noted. Histopathological analysis was suggestive of pancreatic ES following which the patient underwent five cycles of chemotherapy. Following this, she underwent 18F FDG PET/CT which showed hypermetabolic large mass arising from body and tail of pancreas with areas of internal necrosis along with left adrenal metastasis, retroperitoneal lymphadenopathy, a massive left pleural effusion and compressive atelectasis of left lower lobe. The patient expired within a week following PET/CT. Conclusions EES most often presents in the late stage of the disease with vague symptoms. Timely diagnosis and initiation of treatment is of utmost importance considering the aggressiveness of the tumor. Establishing a diagnosis of Ewing sarcoma is especially difficult when the mass is arising from the pancreas. Imaging, histopathology and immunohistochemistry (IHC) play a key role in accurate diagnosis of such masses. 18F FDG PET/CT can be useful for detecting local and distant spread, operability, treatment planning and evaluation of response to chemotherapy.

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Peripheral neuroectodermal tumour of the kidney (Ewing’s sarcoma): Restaging with 18F-fluorodeoxyglucose (FDG)-PET/CT

Cited by 3 publications

References 29 publications

Primary Ewing sarcoma of the kidney

Primary Ewing sarcoma of the kidney

Ewing’s sarcoma of the right kidney with multiple metastasis on PET/CT

Primary pancreatic Ewing sarcoma with metastases on FDG PET/CT

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