scholarly journals Primary Ewing’s Sarcoma of the Spine in a Two-Year-Old Boy

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Ali J. Electricwala ◽  
Jaffer T. Electricwala
Keyword(s):  
Spinal Canal ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Cauda Equina ◽  
Bone Tumour ◽  
Tracer Uptake ◽  
Tumour Mass ◽  
Gene Testing ◽  
Bone Sarcomas ◽  
Good Improvement

Ewing’s Sarcoma (ES) is a highly malignant bone tumour. It may involve any part of the skeleton but the most frequent parts are the ilium and diaphysis of femur and tibia (Alfeeli et al., 2005; Zhu et al., 2012). Primary ES of the spine is extremely rare (Yan et al., 2011). It accounts for only 3.5 to 14.9 percent of all primary bone sarcomas. The age of presentation ranges from 12 to 24 years (median 21 years) (Ferguson, 1999; Sharafuddin et al., 1992; Klimo Jr. et al., 2009). We report an unusual case of primary ES of the spine in a two-year-old boy, who presented to us with paraparesis and features of cauda equina syndrome. MRI scan showed a tumour mass arising from the pedicle of L4 vertebra invading the spinal canal. Tc-99 bone scan showed increased tracer uptake in L4 vertebra and normal tracer uptake elsewhere in the skeleton. After reaching the diagnosis of a space occupying lesion invading the lumber spinal canal, we performed a decompressive laminectomy and a biopsy was sent which confirmed the diagnosis of ES. Immunohistochemistry showed tumour cells staining positive for CD-99 (specific stain for ES). Gene testing showed an EWS-FLI 1 chimera. Surgery was followed by good improvement in motor signs. The child was then referred to a specialized oncotherapy centre for further treatment, radiation, and chemotherapy. To the best of our knowledge, we are the first to report primary ES of the spine at the age of two years.

scholarly journals Ewing's sarcoma of rib

2018 ◽  
Vol 50 (1-2) ◽  
pp. 41-43
Author(s):  
Sk Moazzem Hossain ◽  
Farjana Kabir ◽  
SM Kamal ◽  
Debasish Kumar Ghosh
Keyword(s):  
Pleural Effusion ◽  
Chest Wall ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Bone Tumour ◽  
Mass Lesion ◽  
College Hospital ◽  
X Ray ◽  
Medical College ◽  
First Rib

Ewing's sarcoma is an uncommon malignant bone tumour occuring in children, adolescents and young adults. We report a case of a 13 year old male admitted to Khulna Medical College Hospital with history of pain and swelling in chest wall for two weeks. Earlier chest X-ray showed a mass lesion in the left upper part of chest wall and erosion of first rib. Subsequent X-ray revealed left sided massive pleural effusion. CT scan revealed a mass lesion in the left upper part of chest wall originated from left first rib and left sided pleural effusion. FNAC from the mass lesion revealed features suggestive of Ewing's sarcoma. Patient was treated with chemotherapy and after first cycle there was significant improvement of all the signs and symptoms.Bang Med J (Khulna) 2017; 50 : 41-43

Experimental Therapies and Clinical Trials in Bone Sarcoma

2010 ◽  
Vol 8 (6) ◽  
pp. 715-725 ◽  
Author(s):  
Rashmi Chugh
Keyword(s):  
Clinical Trials ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Bone Sarcoma ◽  
Pediatric Malignancies ◽  
Experimental Therapies ◽  
Bone Sarcomas ◽  
Made In

Sarcomas originating in the bone represent a challenge for physicians and patients. Because they constitute only 0.2% of all adult malignancies and 6% of pediatric malignancies, resources for studying this disease are often limited.1,2 Nonetheless, significant advancements have been made in the treatment of this disease, and there are ongoing efforts toward improvement. This article discusses recently completed and currently enrolling clinical trials for the 3 most common bone sarcomas: osteosarcoma, Ewing's sarcoma family tumors, and chondrosarcoma.

Chemotherapy in the Management of Osteosarcoma and Ewing's Sarcoma

2007 ◽  
Vol 5 (4) ◽  
pp. 449-455 ◽  
Author(s):  
Scott M. Schuetze
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Disease Patient ◽  
Bone Sarcoma ◽  
The United States ◽  
High Grade ◽  
Medical Oncologists ◽  
Bone Sarcomas ◽  
Localized Disease ◽  
Relapsed Disease

Sarcomas of bone are rare malignancies diagnosed in fewer than 3000 individuals yearly in the United States. Ewing's sarcoma and most osteosarcoma are high-grade neoplasms and account for approximately one half of bone sarcoma cases. Fewer than 20% of patients presenting with localized Ewing's sarcoma or osteosarcoma are cured with surgery alone. Current management typically involves collaboration among orthopedic oncologists, medical oncologists, musculoskeletal radiologists, sarcoma pathologists, and radiation oncologists. Modern multidisciplinary management of Ewing's sarcoma and osteosarcoma has improved the cure rate of patients with localized disease to more than 50%. Primary chemotherapy for high-grade bone sarcomas often involves intensive, multiagent regimens, and few secondary chemotherapy options are available to treat refractory or relapsed disease. Patient participation in clinical trials of novel therapies for Ewing's sarcoma and osteosarcoma should be strongly encouraged.

scholarly journals A DNA methylation-based classifier for accurate molecular diagnosis of bone sarcomas.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 11034-11034
Author(s):  
Shengyang Wu ◽  
Benjamin Thomas Cooper ◽  
Fang Bu ◽  
Christopher Bowman ◽  
Keith Killian ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Synovial Sarcoma ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Clinical Sample ◽  
Methylation Status ◽  
Accurate Diagnosis ◽  
Cpg Sites ◽  
Bone Sarcomas ◽  
Methylation Profiling

11034 Background: Bone sarcomas present a unique diagnostic challenge because of the considerable morphologic overlap between different entities. The choice of optimal treatment, however, is dependent upon accurate diagnosis. Genome-wide DNA methylation profiling has emerged as a new approach to aid in the diagnosis of brain tumors, with diagnostic accuracy exceeding standard histopathology. In this work we developed and validated a methylation based classifier to differentiate between osteosarcoma, Ewing’s sarcoma, and synovial sarcoma. Methods: DNA methylation status of 482,421 CpG sites in 15 osteosarcoma, 10 Ewing’s sarcoma, and 11 synovial sarcoma samples were measured using the Illumina HumanMethylation450 array. From this training set of 36 samples we developed a random forest classifier using the 400 most differentially methylated CpG sites (FDR q value < 0.001). This classifier was then validated on 10 synovial sarcoma samples from TCGA, 86 osteosarcoma samples from TARGET-OS, and 15 Ewing’s sarcoma from a recently published series (Huertas-Martinez et al., Cancer Letters 2016). Results: Methylation profiling revealed three distinct molecular clusters, each enriched with a single sarcoma subtype. Within the validation cohorts, all samples from TCGA were correctly classified as synovial sarcoma (10/10, sensitivity and specificity 100%). All but one sample from TARGET-OS were classified as osteosarcoma (85/86, sensitivity 98%, specificity 100%) and all but one sample from the Ewing’s sarcoma series was classified as Ewing’s sarcoma (14/15, sensitivity 93%, specificity 100%). The single misclassified osteosarcoma sample was classified as Ewing’s sarcoma, and was later determined to be a misdiagnosed Ewing’s sarcoma based on RNA-Seq demonstrating high EWRS1 and ETV1 expression. An additional clinical sample that was misdiagnosed as a synovial sarcoma by initial histolopathology, was accurately recognized as osteosarcoma by the methylation classifier. Conclusions: Osteosarcoma, Ewing’s sarcoma and synovial sarcoma have distinct epigenetic profiles. Our validated methylation-based classifier can be used to provide an accurate diagnosis when histological and standard techniques are inconclusive.

scholarly journals Spectrum of MDP Bone Scan in Paediatric Patients - Experience at NINMAS

2018 ◽  
Vol 19 (1) ◽  
pp. 28-31
Author(s):  
Pupree Mutsuddy ◽  
Shamim MF Begum ◽  
Nasreen Sultana ◽  
Rahima Parveen ◽  
Nabeel Fahmi Ali ◽  
...  
Keyword(s):  
Bone Scan ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Imaging Modality ◽  
Bone Tumour ◽  
Bone Diseases ◽  
Skeletal Survey ◽  
Clinical Indications ◽  
Paediatric Patients ◽  
Clinical Records

Objective: To assess the clinical indications and spectrum of MDP bone scan findings in paediatric patients referred to the National Institute of Nuclear Medicine and Allied Sciences (NINMAS).Materials and Methods: Paediatric patients, age ranged from 2-18 years referred to NINMAS from January 2014 to November 2015 for bone scintigraphy were included in this study. All patients had 99mTc MDP bone scan for various clinical indications. The spectrum of clinical indications and bone scan findings were recorded and analyzed.Results: Total 2323 bone scans with 99mTc MDP were done in NINMAS in the above mentioned period. Among them 91 (3.917%) cases were in paediatric age group. Of which 82 (90.11%) patients with known malignancy were referred for radionuclide skeletal survey. The most common clinical indications were osteosarcoma 30 (32.96%) cases and Ewing’s sarcoma 25 (27.47%) cases followed by five neuroblastoma (5.49%), four (4.39%) rhabdomyosarcoma, three (3.29%) Langerhans cell histocytosis and rest others. Bone scan was positive in 58 (63.7%) cases and normal in 33 (36.3%) cases. Out of 58 cases 38 had features of primary bony lesion, 10 cases had multiple metastases, four cases had primary bone tumour of Ewing’s sarcoma as well as metastases.Conclusion: Bone scan is a popular imaging modality for skeletal survey of paediatric patients in malignancy, both primary and metastatic bone diseases. Bone scanning in paediatric patients contributes a major role in detecting the cause and localizing the pathology of bone. High quality imaging, interpreted by physicians familiar with paediatric diseases, correlation with clinical records and other imaging are mandatory to maximize the benefit.Bangladesh J. Nuclear Med. 19(1): 28-31, January 2016

Survival and signals of response in advanced sarcoma patients enrolled on phase 1 trials in the era of precision oncology and novel immunotherapies.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11063-11063
Author(s):  
Shiraj Sen ◽  
Kenneth R. Hess ◽  
David S. Hong ◽  
Gerald Steven Falchook ◽  
Roberto Pestana ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Soft Tissue ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Phase 1 ◽  
Phase 1 Trials ◽  
Best Response ◽  
Bone Sarcomas ◽  
Us Fda ◽  
Advanced Sarcoma

11063 Background: Few effective US FDA approved therapies exist for refractory, metastatic sarcomas. Many of these patients therefore enroll onto phase 1 clinical trials. Because tumor-specific outcomes are not always reported in less common cancers such as sarcomas, outcomes of sarcoma patients treated with novel immunotherapy and targeted therapy approaches remains unknown. Methods: We analyzed clinical and next generation sequencing data from all sarcoma patients treated on phase 1 trials at MD Anderson Cancer Center (MDACC) and performed logistic and Cox proportional hazards regression analyses to evaluate response rate (RR), median time to progression (mTTP), clinical benefit rate (CBR; defined as CR, PR, or SD > 6 months), and median overall survival (OS). Results: Among the 406 patients with advanced sarcomas (321 soft tissue sarcoma, 85 bone sarcomas) treated on phase 1 trials at MDACC from May 2006 to May 2018, median age was 53 (range 11-84), 48% were female, with a median 3 prior lines of therapy (range 0-9). The most commonly treated soft tissue sarcoma subtypes included leiomyosarcoma (n = 66; 16%), liposarcoma (n = 52; 13%), GIST (n = 44; 11%), UPS (n = 14; 3%), and synovial sarcoma (n = 11; 3%) and most commonly treated bone sarcomas included osteosarcoma (n = 34; 8%), chondrosarcoma (n = 28; 7%), and Ewing’s sarcoma (n = 25; 6%). RR was 7% (95% CI 5, 10), mTTP was 2.9 months (95%CI 2.6, 3.1), CBR was 24% (95% CI 20, 29), mOS was 17.2 months (95% CI 13.8, 20.8). 2 patients had a CR as best response, 1 chondrosarcoma patient treated with an anti-APO2L/Trail agent and 1 Ewing’s sarcoma patient treated with the combination of an IGF1R inhibitor plus mTOR inhibitor. 26 patients (6%) had a PR as best response using novel immunotherapies targeting PD1, PDL1 plus CCR4, CTLA4 plus KIT, and TLR7/8 and novel targeted therapies against TRK, LRRC15, cMET, mTOR, VEGF, MDM2, KIT/PDGFRA, and FGFR. Responses were seen across sarcoma subtypes - ASPS, UPS, myxoid sarcoma, liposarcoma, GIST, carcinosarcoma, clear cell sarcoma, embryonal rhabdomyosarcoma, epitheliod sarcoma, fibrious histiosarcoma, and Ewing’s sarcoma. Conclusions: Our analysis identifies a reasonable survival in heavily pretreated, metastatic refractory sarcoma patients with responses seen with novel targeted therapies and immunotherapies that are not yet US-FDA approved. Biomarker analysis is ongoing to help identify the subset of responders in our cohort. Advanced sarcoma patients should be considered for molecular profiling and early phase clinical trials.

scholarly journals Pelvic Ewing's Sarcoma: A Review from Scottish Bone Tumour Registry

2008 ◽  
Vol 16 (3) ◽  
pp. 333-338 ◽  
Author(s):  
S Bhagat ◽  
H Sharma ◽  
DS Pillai ◽  
MJ Jane
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Bone Tumour

scholarly journals Comparison of MRI and Histopathology with regard to Intramedullary Extent of Disease in Bone Sarcomas

Sarcoma ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Ashish Gulia ◽  
Ajay Puri ◽  
T. S. Subi ◽  
Srinath M. Gupta ◽  
S. L. Juvekar ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Correlation Analysis ◽  
Limb Salvage ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Salvage Surgery ◽  
Limb Salvage Surgery ◽  
Bone Sarcomas ◽  
The Mean ◽  
Extent Of Disease

In today’s era, limb salvage surgery is the procedure of choice and current standard of care in appropriately selected patients of bone sarcomas. For adequate oncologic clearance, preoperative evaluation of the extent of tumor is mandatory. The present study was done to compare measurements of bone sarcomas (osteosarcoma, Ewing’s sarcoma, and chondrosarcoma) as determined by magnetic resonance imaging (MRI) with the histopathological extent seen on resected specimens. We prospectively evaluated 100 consecutive patients with a diagnosis of bone sarcoma who underwent limb salvage surgery between May 2014 and December 2014. The maximum longitudinal (cranio-caudal) dimension of tumor on the noncontrast T1-WI sequence of MRI (irrespective of whether it was pre/postchemotherapy) was compared with the gross dimensions of the tumor on histopathology. The arithmetic mean difference, Wilcoxon signed-rank test, and Spearman’s correlation analysis were used to test the differences and correlation between groups. Mean tumor size on MRI based on the largest extent on MRI was 12.1 ± 4.85 cm (mean ± standard deviation), while it was 10.77 ± 4.6 cm (mean ± standard deviation) on histopathology. In 79 cases, MRI overestimated the extent of disease; the mean was 1.79 cm with a standard deviation of 1.56 cm. When the disease extent was underestimated on MRI (13 cases), the mean was 0.58 cm with a standard deviation of 0.43 cm. In 8 cases (osteosarcoma (7), Ewing’s sarcoma (1)), MRI measurement was equal to histopathology. The Spearman correlation analysis showed a high correlation of tumor length on histopathology with the MRI for all patients (R = 0.948, P<0.0001). We thus conclude that MRI is accurate in delineating the extent of bone sarcomas. A margin of 2 cm from the maximum tumor extent is adequate to ensure appropriate surgical resection.

Primary intradural Ewing’s sarcoma of the cauda equina presenting with acute bleeding

2009 ◽  
Vol 152 (3) ◽  
pp. 563-564 ◽  
Author(s):  
François Vincentelli ◽  
Giuseppe Caruso ◽  
Dominique Figarella-Branger
Keyword(s):  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
Cauda Equina ◽  
Acute Bleeding

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.

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