Intra-neural Ewing’s sarcoma of the upper limb mimicking a peripheral nerve tumour. A report of 2 cases

Summary Ewing’s sarcoma is a malignant round cell tumour of bone commonly affecting children and young adults. Intra-neural Ewings is very rare form of extraosseous Ewing’s sarcoma (EES), posing diagnostic and therapeutic challenges. We report two cases of intra-neural EES presenting with elbow pain...

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Bibliographic Details
Published in:Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2011-06, Vol.64 (6), p.e153-e156
Main Authors: Mohan, Anita T, Park, Derek H, Jalgaonkar, Azal, Alorjani, Mohammed, Aston, William, Briggs, Tim
Format: Article
Language:English
Subjects:
Aged
Biopsy
Bone Neoplasms - diagnosis
Bone Neoplasms - surgery
Female
Follow-Up Studies
Humans
Intra-neural Ewing’s sarcoma
Magnetic Resonance Imaging
Neoplasm Invasiveness
Neuroectodermal Tumors, Primitive, Peripheral - diagnosis
Peripheral PNET
Plastic Surgery
Sarcoma, Ewing - diagnosis
Sarcoma, Ewing - surgery
Surgery
Treatment
Ulna
Ulnar Nerve
Young Adult
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Summary:Summary Ewing’s sarcoma is a malignant round cell tumour of bone commonly affecting children and young adults. Intra-neural Ewings is very rare form of extraosseous Ewing’s sarcoma (EES), posing diagnostic and therapeutic challenges. We report two cases of intra-neural EES presenting with elbow pain and swelling, mimicking an upper limb peripheral nerve sheath tumour. Following a CT guided biopsy to confirm diagnosis, the patients were treated with a combination of surgical resection, chemotherapy and radiotherapy. These cases highlight the potential diagnostic challenges as their presentation can be misleading due to the non-specificity of symptoms. These are highly aggressive tumours with the propensity to metastasise. We review importance of collective radiological and immunohistochemical analysis followed by early, aggressive multimodal treatment within a multidisciplinary setting. This provides the best prognosis in the context of upper limb peripheral nerve tumours.
ISSN:1748-6815
1878-0539
DOI:10.1016/j.bjps.2011.01.010