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Case Reports
. 2025 Mar-Apr;30(2):231-233.
doi: 10.4103/jiaps.jiaps_214_24. Epub 2025 Jan 2.

Primary Ewing Sarcoma of the First Rib Presenting as Superior Vena Cava Syndrome: Case Report of a Young Male

Deepak Kumar Garnaik  1 , B Jagdish  1 , Enono Yhoshu  1 , Vivek Singh  2 , Raja Lahiri  3 , Satya Sree Balija  1
Affiliations
Case Reports

Primary Ewing Sarcoma of the First Rib Presenting as Superior Vena Cava Syndrome: Case Report of a Young Male

Deepak Kumar Garnaik et al. J Indian Assoc Pediatr Surg. 2025 Mar-Apr.

Abstract

Ewing sarcoma is a malignant tumor of young adults comprising about 10%-15% of all bone sarcomas. Commonly, the long bones are affected but it can also originate from the rib, pelvis and spine. We present a large Ewing sarcoma in a 16-year-male, arising from the first right rib and manifesting with superior vena cava syndrome.

Keywords: Adolescent; Ewing sarcoma; chest wall tumors; superior vena cava syndrome.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
(a) At Presentation-Tumor Size: 12 cm × 13 cm × 12 cm. Compression on the mediastinal structures including inferior vena cava and right main bronchus (b) Post 2 cycles of neoadjuvant chemotherapy (NACT), Size - 7.8 cm × 7.5 cm × 9 cm (c) Post 5 cycles of NACT, Size- 3.6 cm × 6 cm × 4.2 cm (d) Three-dimensional Reconstruction image: Tumor (yellow arrow) seen to be in close approximity to mediastinal structures, subclavian vessels, involving 1st rib (green arrow)
Figure 2
Figure 2
(a) Skin incision: right sided neck incision with infraclavicular extent (b) Skin and subcutaneous flap raised and exposure of clavicle. Marking of osteotomy site on clavicle (c) Tumor with erosion of the first rib (yellow arrow) subclavian vessels retracted (white arrow) (d) Clavicular plate placement (e) Muscle reconstruction and clavicle covered with pectoralis major flap (f) Follow-up chest X-ray: well expanded lung with the clavicular plate
See this image and copyright information in PMC

References

    1. Widhe B, Widhe T, Bauer HC. Ewing sarcoma of the rib – Initial symptoms and clinical features: Tumor missed at the first visit in 21 of 26 patients. Acta Orthop. 2007;78:840–4. - PubMed
    1. Girelli L, Luksch R, Podda MG, Meazza C, Puma N, Scanagatta P, et al. Surgical approach to primary tumors of the chest wall in children and adolescents: 30 years of mono-institutional experience. Tumori. 2016;102:89–95. - PubMed
    1. Lin D, Zhu X, Tian L, Qin C, Dong J, Zhou Q. A huge Ewing's sarcoma of the rib presenting with superior vena cava syndrome and dysphagia. Thorac Cancer. 2022;13:1726–30. - PMC - PubMed
    1. Melliere D, Ben Yahia NE, Etienne G, Becquemin JP, de Labareyre H. Thoracic outlet syndrome caused by tumor of the first rib. J Vasc Surg. 1991;14:235–40. - PubMed
    1. Rehemutula A, Zhang LI, Yu C, Chen L, Gu Y. Thoracoscopy-assisted first rib resection for the treatment of thoracic outlet syndrome caused by fibrous dysplasia: A report of two cases. Exp Ther Med. 2015;9:2241–4. - PMC - PubMed

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