A case of extraskeletal Ewing sarcoma originating from the visceral pleura

Abstract

Extra skeletal Ewing Sarcoma (EES) is a rare entity which predominantly occurs in adolescents and young adults. It usually arises from the soft tissues of the trunk or the extremities. We present a case of EES arising from the left visceral pleura in a 21 year old female patient who presented to the emergency room of our institution with fever, productive cough and sternal pain radiating to the back for the last 3 days. Chest radiograph was firstly performed, followed by chest CT examination. Finally open lung biopsy revealed a small round cell malignancy. The mass was resected and the histological examination revealed Extra skeletal Ewing Sarcoma (EES) of the visceral pleura without involvement of the adjacent lung. Secondary multiple nodules at the lateral wall of the pleura were also noticed and so postoperative multiagent chemotherapy was performed. EES should be considered in the differential diagnosis of any patient, especially adolescents or young adults, with a soft tissue mass of the trunk or the extremities.

Keywords: extraskeletal Ewing Sarcoma; soft tissue tumor; visceral pleura.

Figure 1. Chest Scanogram demonstrating the opacification of the left hemithorax and the mediastinal shift to the right

Figure 2. CT examination after contrast administration revealing a large pleural effusion and a heterogeneous, enhancing mass located at the left pleural cavity (a, b)

Figure 3. CT examination after contrast administration demonstrating multiple enhancing nodules at the lateral wall of the pleura (a, b)