Ewing's Sarcoma Multifocal Metastases to Temporal and Occipital Bone: A Rare Presentation

Abstract

Ewing's sarcoma (ES) is a common malignant bone tumour seen to involve long bones, flat pelvic bones and ribs and vertebrae in majority of cases. Here, we present a rare case of aggressive primary ES of pelvic bones with multifocal metastases to temporal bone and occipital bone. The patient presented with facial palsy and an occipital swelling, and was referred for chemotherapy.

Keywords: Metastasis; Multiple; Skull.

[Table/Fig-1a,b]:

(a) Clinical photograph of the patient showing deviation of angle of mouth towards left side and no movement on right side of face, suggestive of right sided lower motor neuron type facial nerve palsy. (b) Clinical photograph of the patient showing an occipital swelling with stretched overlying skin and multiple dilated veins

[Table/Fig-2a,b]:

CECT Temporal bone showing soft tissue attenuation contents in the right mastoid air cells and middle ear, with erosion of right ear ossicles, tegmen tympani and scutum. (a) Axial section, and (b) Coronal section

[Table/Fig-3a,b]:

(a) Histopathology showing diffuse arrangement of small round uniform cells with scant cytoplasm, round nucleus with small nucleoli showing mitosis (arrow) (H&E, 200X); (b) Strong membranous expression of CD99 by the tumor cells on immunohistochemistry (400X)