A Rare Case of Sinonasal Ewing Sarcoma With Radiologic-Pathologic Correlation

An 89-year-old male presented with syncope and worsening difficulty in breathing through the left nostril. Computed tomography demonstrated a tumor in the anterior ethmoid air cells and maxillary sinus, which extended into the frontal lobe. Magnetic resonance imaging similarly demonstrated an aggres...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2023-08, Vol.15 (8)
Main Authors: Worthy, Jennifer, Ganguli, Malika P, Kile, Mahlon R, Satei, Alexander M, Mills, Nicholas D
Format: Article
Language:English
Subjects:
Biopsy
Bones
Cancer
Cardiovascular disease
Case reports
Cytoplasm
Edema
Ewings sarcoma
Head & neck cancer
Magnetic resonance imaging
Melanoma
Oncology
Pathology
Radiology
Sinuses
Stains & staining
Throat cancer
Tomography
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Summary:An 89-year-old male presented with syncope and worsening difficulty in breathing through the left nostril. Computed tomography demonstrated a tumor in the anterior ethmoid air cells and maxillary sinus, which extended into the frontal lobe. Magnetic resonance imaging similarly demonstrated an aggressive lesion. This mass was difficult to differentiate from more commonly seen lesions at this location such as an esthesioneuroblastoma or nasopharyngeal carcinoma. Direct visualization, biopsy, and subsequent pathologic analysis eventually confirmed the diagnosis of malignant Ewing sarcoma (EWS).Our case explores the radiological findings of EWS originating from the ethmoid sinus, compares EWS with other common carcinomas in the same location, confirms the diagnosis through pathological correlation, and investigates the prognosis and treatment of these lesions. This case highlights the importance of a multidisciplinary approach to diagnose EWS when it occurs in an atypical location. The clinical team relied on input from the radiology, surgery, ENT, neurology, and pathology departments to make an accurate diagnosis and plan treatment for this aggressive tumor.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.43708