Painful palatal swelling

Ewing's sarcoma often presents as a mass with local, intermittent pain.1 Associated malaise, low-grade fever, fatigue, leucocytosis, and elevated ESR may be misconstrued as an infectious process, such as a dental infection, and ultimately delay diagnosis.2 Nearly one-third of patients present w...

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Bibliographic Details
Published in:The Lancet (British edition) 2010-04, Vol.375 (9721), p.1224-1224
Main Authors: Klieb, Hagen BE, Dr, Duchnay, Michael, DMD, Skeete, Desiree, MD, Leong, Iona T, BDS, Blackstein, Martin E, MD
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Chemotherapy
Diagnosis, Differential
Female
General aspects
Humans
Internal Medicine
Leukemia
Lymphoma
Maxillary Neoplasms - pathology
Medical sciences
Melanoma
Palatal Neoplasms - pathology
Palatal Neoplasms - secondary
Sarcoma
Sarcoma, Ewing - pathology
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Summary:Ewing's sarcoma often presents as a mass with local, intermittent pain.1 Associated malaise, low-grade fever, fatigue, leucocytosis, and elevated ESR may be misconstrued as an infectious process, such as a dental infection, and ultimately delay diagnosis.2 Nearly one-third of patients present with metastatic disease at the time of diagnosis; the most common sites of metastasis are the lung and bone.3 Microscopic differential diagnosis includes lymphoma/leukaemia, melanoma, rhabdomyosarcoma, undifferentiated carcinoma, and small cell carcinoma neuroectodermal type. A broad immunohistochemical panel should be used to aid differentiation in conjunction with molecular studies to identify chromosomal translocations associated with Ewing's sarcoma.2 Head and neck Ewing's sarcoma is uncommon.3 Although mostly considered a disease of children and adolescents,3 Ewing's sarcoma can occur at any age.4 Because of the few adult patients, conclusive clinical data remain elusive and treatment is largely based on individual tolerance to paediatric chemotherapy regimens, together with local radiation and surgical/ablative therapies.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(10)60053-0