Ewing Sarcoma of Left Thigh With Nodal, Paraspinal and Soft Tissue Metastatic Lesions: A Case Report

Introduction: Ewing sarcoma is a rare and highly aggressive malignancy, mostly involving the axial skeleton. Ewing sarcoma usually affects children and young adults under 20. Usually presenting as a painful swelling and discomfort worsening over time. Case report: We present a case of a 19-year-old...

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Main Authors: Radeyah Waseem, Muskan Seher, Sohiba Ghazal, Edrees Khan, Hussain Haider Shah, Muhammad Sheheryar Hussain
Format: Article
Language:English
Published: SAGE Publishing 2024-11-01
Series:Clinical Medicine Insights: Case Reports
Online Access:https://doi.org/10.1177/11795476241302545
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author Radeyah Waseem
Muskan Seher
Sohiba Ghazal
Edrees Khan
Hussain Haider Shah
Muhammad Sheheryar Hussain
author_facet Radeyah Waseem
Muskan Seher
Sohiba Ghazal
Edrees Khan
Hussain Haider Shah
Muhammad Sheheryar Hussain
author_sort Radeyah Waseem
collection DOAJ
description Introduction: Ewing sarcoma is a rare and highly aggressive malignancy, mostly involving the axial skeleton. Ewing sarcoma usually affects children and young adults under 20. Usually presenting as a painful swelling and discomfort worsening over time. Case report: We present a case of a 19-year-old female with no known co-morbidities presenting in the Emergency Department with complaints of fever and backache for the past 2 weeks and bilateral lower limb weakness for more than a week. She was started on steroids and broad-spectrum antibiotics and packed cell volume due to low hemoglobin. The screening MRI of the cervical and dorsal spine without contrast revealed signal abnormalities in the vertebral bodies at multiple levels (C2, C5, C6, C7, T1, and T3), as well as within the spinous processes and interspinous musculature. Further evaluation with contrast-enhanced MRI was recommended. The contrast-enhanced MRI showed straightening of the cervical and dorsal spine due to muscular spasm. Additionally, there were small soft tissue components in the left paravertebral region at the level of D3, extending into the epidural space, and epidural components encasing the thecal sac at the levels of D5, D9, and D10 suggestive of neoplastic lesions, most likely metastasis. The morphological and immunohistochemical correlation established the diagnosis of Ewing Sarcoma of the left thigh with nodal, para-spinal, and soft tissue metastatic lesions. Conclusion: Ewing Sarcoma is generally reported in the pediatric population and may come into clinical view based on a plethora of signs and symptoms. Appropriate imaging in the form of X-rays, CT scans, and MRI must be employed to correctly diagnose, and stage the condition.
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spelling doaj-art-dbef80a783b44d609982cc70cdc50e282024-11-28T09:03:44ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762024-11-011710.1177/11795476241302545Ewing Sarcoma of Left Thigh With Nodal, Paraspinal and Soft Tissue Metastatic Lesions: A Case ReportRadeyah Waseem0Muskan Seher1Sohiba Ghazal2Edrees Khan3Hussain Haider Shah4Muhammad Sheheryar Hussain5Department of Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, PakistanDepartment of Internal Medicine, Dow University of Health Sciences, Karachi, PakistanIntroduction: Ewing sarcoma is a rare and highly aggressive malignancy, mostly involving the axial skeleton. Ewing sarcoma usually affects children and young adults under 20. Usually presenting as a painful swelling and discomfort worsening over time. Case report: We present a case of a 19-year-old female with no known co-morbidities presenting in the Emergency Department with complaints of fever and backache for the past 2 weeks and bilateral lower limb weakness for more than a week. She was started on steroids and broad-spectrum antibiotics and packed cell volume due to low hemoglobin. The screening MRI of the cervical and dorsal spine without contrast revealed signal abnormalities in the vertebral bodies at multiple levels (C2, C5, C6, C7, T1, and T3), as well as within the spinous processes and interspinous musculature. Further evaluation with contrast-enhanced MRI was recommended. The contrast-enhanced MRI showed straightening of the cervical and dorsal spine due to muscular spasm. Additionally, there were small soft tissue components in the left paravertebral region at the level of D3, extending into the epidural space, and epidural components encasing the thecal sac at the levels of D5, D9, and D10 suggestive of neoplastic lesions, most likely metastasis. The morphological and immunohistochemical correlation established the diagnosis of Ewing Sarcoma of the left thigh with nodal, para-spinal, and soft tissue metastatic lesions. Conclusion: Ewing Sarcoma is generally reported in the pediatric population and may come into clinical view based on a plethora of signs and symptoms. Appropriate imaging in the form of X-rays, CT scans, and MRI must be employed to correctly diagnose, and stage the condition.https://doi.org/10.1177/11795476241302545
spellingShingle Radeyah Waseem
Muskan Seher
Sohiba Ghazal
Edrees Khan
Hussain Haider Shah
Muhammad Sheheryar Hussain
Ewing Sarcoma of Left Thigh With Nodal, Paraspinal and Soft Tissue Metastatic Lesions: A Case Report
Clinical Medicine Insights: Case Reports
title Ewing Sarcoma of Left Thigh With Nodal, Paraspinal and Soft Tissue Metastatic Lesions: A Case Report
title_full Ewing Sarcoma of Left Thigh With Nodal, Paraspinal and Soft Tissue Metastatic Lesions: A Case Report
title_fullStr Ewing Sarcoma of Left Thigh With Nodal, Paraspinal and Soft Tissue Metastatic Lesions: A Case Report
title_full_unstemmed Ewing Sarcoma of Left Thigh With Nodal, Paraspinal and Soft Tissue Metastatic Lesions: A Case Report
title_short Ewing Sarcoma of Left Thigh With Nodal, Paraspinal and Soft Tissue Metastatic Lesions: A Case Report
title_sort ewing sarcoma of left thigh with nodal paraspinal and soft tissue metastatic lesions a case report
url https://doi.org/10.1177/11795476241302545
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