Lumbar spine Ewing sarcoma: A report of a rare localization

Abstract

Introduction: Ewing sarcoma is an aggressive tumor characterized by small round cells and diffuse CD99 positivity seen mainly in Caucasian childhood and adolescent demographics. Ewing sarcoma of spinal origin accounts for approximately 3-9 % of cases most of these cases affecting the sacrum, therefore lumbar lesions are considered quite rare.

Case report: We report a case of lumbar Ewing sarcoma in a 6-year-old female who presented with back pain and neurological symptoms of spinal compression such as lower limb weakness, constipation, and urinary retention. MRI imaging confirmed the presence of a mass located at the level of L4 and L5 vertebrates causing spinal cord compression, The patient underwent local resection of the tumor, and a biopsy was sent for histology and immunophenotyping which affirmed the diagnosis of Ewing sarcoma. The patient was referred to an oncology center for follow-up chemotherapy.

Clinical discussion: Ewing sarcoma is the second most common tumor of childhood and adolescence. However, a tumor arising from the spine is considered rare. It presents with localized symptoms of pain and fever but may cause neural compression symptoms. Accurate diagnosis relies mainly on radiological scans, histology, and immunohistochemical analysis.

Conclusion: Although Ewing sarcoma of the lumbar spine is rare, it should always be considered among pediatric populations developing localized fever and pain. Early detection is crucial to avoid undesired outcomes.

Keywords: Case report; Ewing sarcoma; Lumbar; Paediatrics.

Fig. 1

MRI imaging of the spine shows the tumor in (A) the sagittal plane, (B): the coronary plane, (C): T2-weighted transverse plane, and (D): T1-weighted transverse plane.

Fig. 2

(A). Small round cell tumor (B). Immunostaining with anti CD99 antibody: diffuse membrane staining (C). negative SYN.