Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Ewing's Sarcoma
- Radiologic Findings
- Chest radiographs show a well-defined, 10cm in diameter, soft tissue mass in left lower anterior hemithorax. On CT scans two different components are seen within the mass; one has a heterogeneous solid mass and the other has a cystic lesion. Left 5th rib is destructed and cortical margins of the rib spread out.
On cut section of the mass (Fig.5), the mass has two main compartments like CT sections. The lesion is originated from the rib without invasion of pleura and lung, histologically.
- Brief Review
- Ewing sarcoma is a relatively common, highly malignant bone tumor that typically occurs in adolescents and young adults aged 10-25 years. The ribs are frequent sites of primary Ewing tumor accounting for about 10-12% of all cases. However, Ewing’s sarcoma originating from the adult rib is rare in clinical practice.
Radiographically, the lesions may be predominantly lytic or sclerotic or show a combination of bone destruction and secondary reactive changes. In some patients bony changes are subtle and are obscured initially by frequently associated large extrapleural masses or pleural fluid. Abnormalities of the affected ipsilateral hemithorax varied from subtle, isolated rib involvement to solitary rib involvement accompanied by complete opacification of the hemithorax.
Additionally, extraskeletal Ewing's sarcoma is now considered as a single entity of primitive neuroectodermal tumor and Askin's tumor. They are infrequent but highly aggressive tumors that involve the chest wall.
- References
- 1. Resnick D. Bone and Joint Imaging. 2nd ed. W.B.Saunders Company, Philadelphia, 1996:1055-1059
- Keywords
- Rib, Malignant tumor,