Primary Ewing’s Sarcoma of the Spine: About a Case

Abstract

Ewing’s sarcoma is a primary malignant bone tumor affecting individuals in the second decade of life. Primary sarcomas of the spine are rare and the occurrence of primary Ewing’s sarcoma in the spine is very rare. There are 2 types of Ewing’s sarcoma of the spine, Ewing’s sarcoma of the sacral spine which is very aggressive with a poor prognosis and Ewing’s sarcoma of the non-sacral spine which is an extremely rare occurrence. The patient may have a neurological deficit when the tumor extends into the spinal canal, causing compression of the spinal cord. Magnetic resonance imaging (MRI) is very sensitive in diagnosing the tumor and Evaluation of the extent of the tumor. Here, we report the case of a 12-year-old boy who presented with low back pain, weakness of both lower limbs and bilateral spastic paraplegia progressively evolving since 1 month. The CT and MRI scans showed the presence of a tissue lesion process centered on the vertebral body of L1, heterogeneously enhanced after injection of Gadolinium respecting the posterior arch, without bulging of the posterior wall with epiduritis, endocanal extension and spinal cord compression. The patient underwent decompression with surgical biopsy and posterior stabilization of the spine. Histopathology and immunohistochemistry studies confirmed the diagnosis of Ewing’s sarcoma and the patient was referred to an oncopediatric center for combined chemotherapy and radiotherapy, but died at home a few days later before the start of treatment.

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

“…Initial chemotherapy and local radiotherapy might be administered before surgery with the aim to shrink bulky and unresectable tumors, to eradicate micrometastases and for acute relief of epidural compression, but it should be noted that there is a variable sensitivity to radiation and chemotherapy due to biological heterogenecity 1 …”

“…13 Initial chemotherapy and local radiotherapy might be administered before surgery with the aim to shrink bulky and unresectable tumors, to eradicate micrometastases and for acute relief of epidural compression, but it should be noted that there is a variable sensitivity to radiation and chemotherapy due to biological heterogenecity. 1 Although, local radiotherapy had a considerable place in the management of locally extended or unresectable spine EWS especially with epidural compression or with poor chemotherapy response, many authors emphasized the local control superiority of wide surgical resection R0 in patients with good response following induction chemotherapy. In the other hand, safe margins tumor resection, when technically achievable, allows to avoid epidural and local skin and soft tissues potential complications of radiotherapy.…”

“…Primary Ewing's Sarcoma (EWS) of the spine is extremely rare. It accounts for only 3.5%–14.9% of all primary bone sarcomas 1,2 . It is characterized by a high proliferative and invasive potential and a confusing variety of imaging manifestations in adult patients 3 .…”

“…It accounts for only 3.5%-14.9% of all primary bone sarcomas. 1,2 It is characterized by a high proliferative and invasive potential and a confusing variety of imaging manifestations in adult patients. 3 Nonspecific signs are often in the first place and the delay from the onset of symptoms to the diagnosis can take months which can worsen the prognosis.…”

Post-Radiotherapy Complications in Ewing Sarcoma: A Case Report and Literature Review

“…It primarily impacts children and adolescents. With 95% of the population under 25, it is characterized by high rates of development and growth [1][2][3][4][5][6][7][8]. Males are 1.5 times more inclined than females to develop it [1,5,8].…”