Document Type: Case Reports

Authors

1 Dept. of Pathology, J.N. Medical College, AMU, Aligarh, INDIA

2 Dept. of Orthopedics, J.N. Medical College, AMU, Aligarh, INDIA

Abstract

Ewing's sarcoma (ES) is a highly malignant neoplasm of childhood and adolescence seen commonly in both axial and appendicular skeleton but uncommonly in acral region. Ewing’s tumor in the hand is extraordinarily rare. Radiological features are variable and can mimic other common lesions. We present a case of 13 year old female, with complaints of pain and swelling in right hand, which on X-ray showed periosteal reaction, giving a sun burst appearance and provisional diagnosis of osteosarcoma was made. The patient was operated and histopathological diagnosis of ES was confirmed. Histopathological examination remains the mainstay of diagnosis, supported by immunochemistry and cytogenetic studies. Surgical extirpation with chemotherapy is the therapeutic regimen of choice. We intend to report this case, because it is very rare location and the radiological features can mimic other lesions which commonly occur in this location like chronic osteomyelitis so it can be easily missed especially at preliminary evaluations.
 

Keywords

  1. Ewing J. Diffuse endothelioma of bone. Proc NY Pathol Soc 1921; 21: 17–24.
  2. Oshigome S, Machinami R, Sorensen PH. Ewing’s Sarcoma/ Primitive Neuroectodermal Tumor. In WHO Classification of tumor. Pathology and Genetics of Tumors of Soft Tissue and Bone. Ed by Fletcher CDM, Unni KK and Mertens F. Lyon. IARC Press. 2002.
  3. Kissane JM, Askin FS, Foulkes M, Stration LB and Shireley SF. Ewing's Sarcoma of the Bone, Clinico-Pathologic Aspects of 303 Cases for the Intergroup Ewing's Sarcoma Study. Hum Pathol 1983;14(9):773-9.
  4. Escobedo EM, Ann G. Bjorkengren AG, Moore SG. Ewing’s sarcoma of the hand. AJR Am J Roentgenol 1992(1);159:101-2.
  1. Iwamoto Y. Diagnosis and Treatment of Ewing's Sarcoma. Jpn J Clin Oncol 2007; 37(2):79-89.
  1. Terrence JJ, Varghese M, Sankaran B, Thirumagal. Ewing's Sarcoma Of The Distal Phalanx Of Little Finger. The Internet Journal of Oncology. 2007;4(1); DOI: 10.5580/2156.
  2. Bacci G, Toni A, Avellam M, Manfrini M, Sudanese A, Ciaroni D, et al. Long-term results in 144 localized Ewing's sarcoma patients treated with combined therapy. Cancer 1989;63(8):1477–86.
  3. Shirley SK, Askin FB, Gilula LA, Vietti TJ, Thomas PR, Siegal GP, et al. Ewing's sarcoma in bones of the hands and feet: a clinicopathologic study and review of the literature. J Clin Oncol 1985;3(5):686-97.
  4. Mohan V, Gupta RP. Ewing's sarcoma of the small bones of hands and feet. Indian J Radiol Imaging 2002;12(3):403-5.