Nonmetastatic Ewing’s Sarcoma of the Lumbar Spine in an Adult Patient (original) (raw)
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European Spine Journal, 2009
The objective of this study is to determine the best local treatment combined with neoadjuvant chemotherapy for ESFT of the spine and sacrum, for the best local treatment for Ewing sarcoma family tumors (ESFT) according to the primary site is still unclear. Nowadays surgery is used in local treatment of ESFT, but literature is scarce on the best local treatment in sites where surgery is problematic, such as the spine. This study evaluates the outcome and the rate of local recurrence of ESFT in the spine and sacrum when treated with neoadjuvant chemotherapy, and locally by radiotherapy alone or surgery, followed by reduced doses of radiotherapy. Forty-three patients with nonmetastatic ESFT located in the spine and sacrum were treated at our institution between 1983 and 2000 with neoadjuvant chemotherapy, and locally by radiotherapy alone in 26 cases, and surgery followed by radiotherapy at reduced doses in 17. The 5-and 10-year
Primary Ewing's Sarcoma of the Spine: Four Case Report
KYAMC Journal, 2019
Ewing's sarcoma is a common malignancy of the bone and soft tissues in pediatric patients. It mostly affects the long bones and pelvis, and less commonly the flat bones and vertebrae. Primary Ewing's sarcoma affecting the spine is very rare. The patient has non-specific symptoms for a prolonged period of time before the correct diagnosis is given. Patients can present with acute paraplegia due to spinal cord compression, which needs prompt surgical intervention. Early diagnosis and treatment are important for neurological recovery. The definitive management includes three main modalities: surgery, radiotherapy and combination chemotherapy. Adequate surgical excision may not be feasible because of anatomical limitations and local control is mainly achieved by radiotherapy. Because of the low incidence of these tumors, a multitude of therapeutic strategies have been employed with varying success. Currently there are no clinical guidelines outlining optimal management KYAMC Jou...
Primary Ewing sarcoma of the spine: Report of two cases
Annals of Saudi medicine, 1993
Ewing sarcoma is a primary bone tumor which was originally described by Lucke in 1866 but was defined in such detail by Sir James Ewing in 1921 that it is now associated with his name [1]. This tumor involves the spine primarily in 3.5% to 14.9% r~~ases [2,3]. The review of 22 cases of Ewing Sarcoma of the spine by Pilepich et al in 1981 [4] remains the largest study of this pathology in such location in the literature and apart from a few smaller series [3,5], most of the documentation of Ewing sarcoma of the spine has been by isolated case reports [6-8]. Considering the worldwide rarity of primary spinal Ewing sarcoma, we were surprised to encounter two cases among the 30 cases of spinal tumors treated in our unit over the last seven years [9]. There are a number of articles reflecting on the experience with Ewing sarcoma in Saudi Arabia [10-12]. However, to our knowledge, in none of these reports was the spine the primary site of the tumor. We feel justified, therefore, in presenting our t•..') cases to highlight awareness of clinicians to the v~..;asionalinvolvement of the spine as a primary site of Ewing sarcoma, which should be considered in the differential diagnosis of spinal tumors causing cord compression. Case Histories The clinical characteristics of the two cases appear in the Table (Figures 1-3). The chest x-ray, abdominal ultrasound, skeletal survey and isotope bone scans for both cases were normal.
Ewing??s Sarcoma of the Mobile Spine
Spine, 2005
Objectives: To evaluate the role of enbloc resection on the oncological outcome of patients with Ewing's sarcoma of the mobile spine treated with systemic multiagent chemotherapy combined with radiation therapy. While the role of chemotherapy and radiation therapy is well known and accepted in the treatment of Ewing sarcoma, there is no consensus on the role of enbloc resection in those tumors occurring in the mobile spine and, therefore, it can be difficult to conclude the decision making process, particularly if to achieve a tumorfree margin resection functionally relevant structures should be sacrificed. The study design of this work was the retrospective analysis of a series of 27 cases of Ewing sarcoma of the mobile spine homogeneously treated.
Primary Ewing Sarcoma of Lumbar Spine With Massive Intraspinal Extension
Pediatric Neurology, 2008
Primary vertebral Ewing sarcoma-primitive neuroectodermal tumor is uncommon. Although epidural extension has been seen in such tumors, cases with massive intraspinal involvement are decidedly rare. Here we present the case of a 4-year-old girl with back pain and difficulty walking. Magnetic resonance imaging showed a mass filling the spinal canal from T 11 to the L 3 /L 4 levels. Vertebral involvement with extension into the paraspinal soft tissue through neural foramina was seen. Histologically, a small-blue-cell tumor with strong membranous CD99 reactivity was noted. Molecular analysis revealed translocation t(11;22)(q24;q12), thus confirming the diagnosis of Ewing sarcoma-primitive neuroectodermal tumor. Our case emphasizes that vertebral Ewing sarcoma-primitive neuroectodermal tumor may present with massive intraspinal extension and should be included in the differential diagnosis of intraspinal lesions.
Journal of Bone Oncology
Many patients with Ewing sarcoma (ES) of the mobile spine present with neurologic symptoms leading to emergency decompressive surgery. Only rarely is optimal treatment involving neo-adjuvant chemotherapy followed by en bloc excision possible. The purpose of this study was to study treatment, neurologic and oncologic outcome in patients with ES of the mobile spine. Methods: Twenty-four patients diagnosed between 1986 and 2012 were identified through the Scandinavian Sarcoma Group registry. Charts were reviewed in order to assess details in patient characteristics, neurologic status, treatment and outcome. Prognostic factors were analyzed with respect to local control, disease-free survival and overall survival. Results: Neurologic symptoms were frequently observed at presentation, being present in 19/23 patients with documented neurologic status. Most (13/19) patients had a complete neurologic recovery regardless of whether or not emergency decompressive surgery was performed. The majority (18/24) of patients were treated with definitive radiotherapy. However, only 9/17 received the recommended dose of ≥ 50.4 Gy. The disease-free and overall survival rates at 10 years were 48% and 57%, respectively. The local recurrence rates were 19% and 27% at 5 and 10 years, respectively. Only year of diagnosis, categorized into periods with significant changes in chemotherapy protocols, was a significant factor for local recurrence, but there was a trend (p = 0.06) for an increased risk of a local recurrence if emergency decompressive surgery was performed. Conclusion: Patients with ES of the mobile have a relatively favorable prognosis. Nonetheless, local recurrence rate is high for this group of patients for which local treatment mainly relies on definitive radiotherapy. Emergency decompressive surgery may increase the risk for local recurrence.
A Case of Ewing's Sarcoma Involving Cervical Spine
Ewing's sarcoma is a highly malignant tumour involving the long bones of extremities together with soft tissues. Our case reports a very unusual case of Ewing's sarcoma of spine. In this report, a 11 years old boy who presented with features of cold compression. After reaching a diagnosis of a space occupying lesion in cervical region, we excised the maps surgically and biopsy was sent which confirmed our diagnosis of swings sarcoma. Surgery was followed by dramatic improvement in motor signs of patient and he was referred to NIMRA for further treatment with radiotherapy and chemotherapy.