scholarly journals Nonmetastatic Ewing’s Sarcoma of the Lumbar Spine in an Adult Patient

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Maurizio Iacoangeli ◽  
Mauro Dobran ◽  
Alessandro Di Rienzo ◽  
Lucia Giovanna Maria di Somma ◽  
Lorenzo Alvaro ◽  
...  
Keyword(s):  
Adult Patient ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Therapeutic Strategies ◽  
Spine Biomechanics ◽  
En Bloc ◽  
Bloc Spondylectomy ◽  
Low Incidence ◽  
Oncological Result ◽  
Definitive Management

Although the spine is frequently involved in metastatic Ewing's sarcoma, primary involvement of the spine, beside sacrum, is much less frequent, especially in adult patients. Because of the low incidence of these tumors, there are currently no clinical guidelines outlining their management and a multitude of therapeutic strategies have been employed with varying success. The definitive management of Ewing's sarcoma of the spine, as in other locations, could include the combination of three main modalities: aggressive surgery, radiotherapy, and combined chemotherapy. Whenever possible, en bloc spondylectomy or extralesional resection is preferable, providing a better oncological result with a longer survival and a better preservation of the spine biomechanics. This is the lesson we learned about the case, we present here, of nonmetastatic lumbar localization by Ewing’s sarcoma in as adult patient.

scholarly journals Primary Ewing’s Sarcoma of Lumbar spine treated with Neo-adjuvant Chemotherapy and Surgery- A Case Report

2020 ◽  
Vol 1 (1) ◽  
Keyword(s):  
Lumbar Spine ◽  
Neoadjuvant Chemotherapy ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Surgical Excision ◽  
Complete Removal ◽  
En Bloc ◽  
Imaging Characteristics ◽  
Bloc Spondylectomy ◽  
Mobile Spine

Primary involvement of mobile spine compared to non-mobile spine is very less in case of Ewing’s sarcoma (ES). There are no fixed guidelines for these types of tumors because of their low incidence. These tumors usually have very high sensitivity to chemotherapy and radiotherapy. Goal for the management of ES of the spine is adequate local control through complete removal of tumor by doing aggressive resection along with restoration of spinal stability and preservation of neurology. En bloc spondylectomy or extralesional resection with wide disease-free margin provides good oncological results with a longer survival. Whenever it is possible to give neoadjuvant chemotherapy, it is always better because it helps to shrink tumor, treat micrometastasis, and make surgical excision easier with wide margin resection. However, in some case of spinal ES, it may not be possible because of neurological compromise and they might have to be addressed first by surgery and neurological decompression. We report here one such cases of primary ES of mobile lumbar spine treated with neoadjuvant chemotherapy and then with en bloc excision of tumor. The clinical picture and imaging characteristics of patient were analyzed as well as the management modalities and outcome has been discussed. Keywords: Ewing’s sarcoma, spine surgery, neoadjuvant chemotherapy, lumbar spine.

scholarly journals Review of therapeutic strategies for osteosarcoma, chondrosarcoma, and Ewing’s sarcoma

2011 ◽  
Vol 17 (8) ◽  
pp. RA177-RA190 ◽  
Author(s):  
Xing Dai ◽  
Wei Ma ◽  
Xijing He ◽  
Rajiv Kumar Jha
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Therapeutic Strategies

scholarly journals Primary Ewing's Sarcoma of the Spine: Four Case Report

KYAMC Journal ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 164-167
Author(s):  
Md Mofazzal Sharif ◽  
Khaleda Parvin ◽  
Umme Iffat Siddiqua ◽  
A.Q. Mehedi Hassan ◽  
Jabed Hossain ◽  
...  
Keyword(s):  
Soft Tissues ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Correct Diagnosis ◽  
Surgical Excision ◽  
Cord Compression ◽  
Acute Paraplegia ◽  
Low Incidence ◽  
Specific Symptoms ◽  
Common Malignancy

Ewing's sarcoma is a common malignancy of the bone and soft tissues in pediatric patients. It mostly affects the long bones and pelvis, and less commonly the flat bones and vertebrae. Primary Ewing's sarcoma affecting the spine is very rare. The patient has non-specific symptoms for a prolonged period of time before the correct diagnosis is given. Patients can present with acute paraplegia due to spinal cord compression, which needs prompt surgical intervention. Early diagnosis and treatment are important for neurological recovery. The definitive management includes three main modalities: surgery, radiotherapy and combination chemotherapy. Adequate surgical excision may not be feasible because of anatomical limitations and local control is mainly achieved by radiotherapy. Because of the low incidence of these tumors, a multitude of therapeutic strategies have been employed with varying success. Currently there are no clinical guidelines outlining optimal management KYAMC Journal Vol. 10, No.-3, October 2019, Page 164-167

scholarly journals A Unique Case of Primary Ewing’s Sarcoma of the Cervical Spine in a 53-Year-Old Male: A Case Report and Review of the Literature

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Marshall T. Holland ◽  
Oliver E. Flouty ◽  
Liesl N. Close ◽  
Chandan G. Reddy ◽  
Matthew A. Howard
Keyword(s):  
Cervical Spine ◽  
Spinal Canal ◽  
Ewing’S Sarcoma ◽  
Treatment Guidelines ◽  
Ewing's Sarcoma ◽  
Histopathological Examination ◽  
Acute Onset ◽  
Rare Presentation ◽  
Low Incidence ◽  
Histopathological Studies

Extraskeletal Ewing’s sarcoma (EES) is a rare presentation, representing only 15% of all primary Ewing’s sarcoma cases. Even more uncommon is EES presenting as a primary focus in the spinal canal. These rapidly growing tumors often present with focal neurological symptoms of myelopathy or radiculopathy. There are no classic characteristic imaging findings and thus the physician must keep a high index of clinical suspicion. Diagnosis can only be definitively made by histopathological studies. In this report, we discuss a primary cervical spine EES in a 53-year-old man who presented with a two-month history of left upper extremity pain and acute onset of weakness. Imaging revealed a cervical spinal canal mass. After undergoing cervical decompression, histopathological examination confirmed a diagnosis of Ewing’s sarcoma. A literature search revealed fewer than 25 reported cases of primary cervical spine EES published in the past 15 years and only one report demonstrating this pathology in a patient older than 30 years of ageage=38. Given the low incidence of this pathology presenting in this age group and the lack of treatment guidelines, each patient’s plan should be considered on a case-by-case basis until further studies are performed to determine optimal evidence based treatment.

227 Surgical Management of Ewing's Sarcoma of the Spine: Survival and Local Control Outcomes

Neurosurgery ◽  
2017 ◽  
Vol 64 (CN_suppl_1) ◽  
pp. 262-262 ◽  
Author(s):  
Laurence D Rhines ◽  
Michael S Dirks ◽  
Stefano Boriani ◽  
Alessandro Luzzati ◽  
Michael G Fehlings ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Local Control ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
En Bloc Resection ◽  
Bloc Resection ◽  
Surgical Margins ◽  
Treatment Modalities ◽  
En Bloc ◽  
Multiple Treatment

Abstract INTRODUCTION Treatment of primary Ewing's sarcoma of the spine is complex and requires multiple treatment modalities. Ambiguity remains regarding the role and optimal type of surgery in the treatment of spinal Ewing's sarcoma. The aim of this study was to quantify mortality and local recurrence rates after surgical treatment of spinal Ewing's sarcoma and to determine whether an Enneking appropriate procedure (en bloc resection with wide/marginal margins) and surgical margins are associated with improved prognosis. METHODS The AOSpine Knowledge Forum Tumor developed a comprehensive multicenter database including demographics, diagnosis, treatment, mortality, and recurrence rate data for Ewing's sarcoma the spine. Patients were analyzed based on surgical margins and Enneking appropriateness. Survival and recurrence were analyzed using Kaplan-Meier curves and log-rank tests. RESULTS >Fifty-eight patients diagnosed with primary Ewing's sarcoma of the spine underwent surgery between 1981 and 2012. Enneking appropriateness of surgery was known for 55 patients; 24 (44%) treated Enneking appropriately (EA) and 31 (56%) treated Enneking inappropriately (EI). The 5-year survival was 75% (N = 18) for EA patients and 52% (N = 16) for EI patients. A statistically significant difference in favor of greater survival for EA-treated patients was found (P = 0.034). Neoadjuvant and postoperative chemotherapy was significantly associated with increased survival (P = 0.008). Local recurrence occurred in 22% (N = 5) of patients with an EA procedure versus 38% (N = 11) of patients with an EI procedure. Although, local control was not significantly different between Enneking cohorts (P = 0.140), surgical margins and previous spine tumor operation were associated with local recurrence (P = 0.025 and P = 0.018, respectively). CONCLUSION Primary spinal Ewing's sarcoma requires multiple treatment modalities. Surgery should be undertaken when an en bloc resection with wide/marginal margins can be performed because an Enneking appropriate surgery is associated with improved survival. En bloc resection with wide/marginal margins is associated with local control.

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