Atypical Presentation of Primary Non-metastatic Ewings Sarcoma of the Lumbosacral Spine-'Cauda Equina Syndrome' Clinically and a 'Tuberculosis mimicking challenge' on MRI-A Case Report
| Autor: | Mohit Kukreja, Chetan Anchan, Vidyadhar G. Telang |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Pathology
medicine.medical_specialty business.industry Cauda equina Cauda equina syndrome medicine.disease Malignancy Sacrum medicine.anatomical_structure Ewing family of tumors Primitive neuroectodermal tumor medicine General Earth and Planetary Sciences Sarcoma business Lumbosacral joint General Environmental Science |
| Zdroj: | American Journal of Medical Case Reports. 5:221-225 |
| ISSN: | 2374-2151 |
| DOI: | 10.12691/ajmcr-5-8-5 |
| Popis: | Introduction: The Ewing family of tumors comprises Ewing's sarcoma (EWS), extraskeletal EWS, primitive neuroectodermal tumor (PNET) of bone and soft tissue, and chest wall tumor (Askin tumor). The translocation t(11; 22) (q24; q12) is identified in more than 90% of cases.EWS is the second most common primary bone malignancy in childhood. In contrast to long bone involvement, delays in spinal EWS diagnosis may occur because symptoms may not be present until neurological deficits occur. To date, although there have been reported cases of EWS in the lumbosacral region, the reported cases are very less and the presentations might drastically differ. Case Presentation: A 14 year old boy comes with a 12 weeks h/o urinary incontinence and constipation. Over the next 4 months, the patient had new-onset intermittent abdominal pain with worsening urinary symptoms.MRI confirmed a diagnosis of Koch's spine. However, the histopathology reported it as an “Ewings sarcoma/Primitive Neuroectodermal Tumor”. Discussion: Ewing’s tumor of sacrum is rare, but should be suspected in low backache in children. Cauda equina syndrome can be a valid presentation for EWS spine. MRI can identify cases early and enables early treatment though it is not specific. Histopathological diagnosis is a must before any definitive management.EWS spine can mimick Tuberculosis both clinico-radiologically, only to be confirmed with a tissue biopsy. Conclusion: Ewing’s sarcoma of the lumbosacral spine can have an atypical presentation and there should be a high degree of suspicion to diagnose it early. |
| Databáze: | OpenAIRE |
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