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Case Reports
. 2018 Jun 29:2:34.
doi: 10.21037/acr.2018.06.07. eCollection 2018.

Surgical management of an adult manifestation of Ewing sarcoma of the spine-a case report

Loay Shoubash  1 , Stephan Nowak  1 , Silke Vogelgesang  2 , Henry W S Schroeder  1 , Jan-Uwe Müller  1
Affiliations
Case Reports

Surgical management of an adult manifestation of Ewing sarcoma of the spine-a case report

Loay Shoubash et al. AME Case Rep. .

Abstract

Ewing sarcoma (ES) is a primary malignant bone tumor. Its occurrence in adults is uncommon. Even rarer is the occurrence in the spine. The prognosis of this tumor in adult patients is unfavorable. In this report, we present the case of a 56-year-old woman with ES localized at the upper thoracic spine, presented with acute incomplete paraplegia. The patient underwent emergency decompressive hemilaminectomy and tumor debulking surgery to decompress the spinal cord. As adjuvant therapy, she received radio-chemotherapy followed by en bloc resection via a combined dorsoventral approach. In the course of the disease, the patient showed a continuous neurological improvement from AISA B to E over the follow up period of 18 months. To date there has been no evidence of tumor recurrence. We report our experience in treating ES of the spine in an adult patient presenting with neurological deficits. We highlight the advantage of en bloc resection of the tumor after spinal stabilization to treat the local disease and alleviating the presenting symptoms.

Keywords: Ewing sarcoma (ES); en bloc resection; sarcoma of the spine.

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Conflict of interest statement

Conflicts of Interest: JU Müller is an unpaid consultant for Söring GmbH, and has received honoraria for lectures/workshops. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Pre- and postoperative MR images. (A) Preoperative sagittal T2-weighted MRI shows a space-occupying lesion at the level Th1/Th2 with spinal cord compression; (B) postoperative sagittal T2-weighted MRI shows the resection of the intraspinal tumor part.
Figure 2
Figure 2
Histopathological images after initial surgery (A) hematoxylin-eosin (HE) composed of sheets of small round blue cells (400×) (B) CD-99 staining 400×: revealing membranous expression of CD99 on immunohistochemistry (C) vimentin staining showing focal positivity (400×).
Figure 3
Figure 3
Postoperative X-rays (A) lateral view and (B) posteroanterior view of the spine after stabilization of the spine and complete resection of the tumor.
See this image and copyright information in PMC

References

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