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01-03-2019 | Case Report

Primary intracranial extraosseous Ewing’s sarcoma

Authors: Amir Humza Sohail, Mohammed Sachal, Muhammad Arslan Arif Maan, Muhammad Soban, Muhammad Salman Khan, Muhammad Ehsan Bari

Published in: Child's Nervous System | Issue 3/2019

Abstract

Introduction

Common sites of occurrence of extraosseous Ewing’s sarcoma include the soft tissues and bones of the lower extremity, 12 paravertebral, and retroperitoneal regions. Primary intracranial Ewing’s sarcoma/pPNET is usually intraparenchymal located 13 when supratentorially, and an extraaxial epidural tumor radiographically mimicking a meningioma is extremely rare.

Case Presentation

A 20-year14 old male presented to the emergency department with a 1-day history of drowsiness, headache, and fever. Neurological exam15 ination revealed decreased muscle strength (4/5) in the left lower limb. Head computed tomography scan showed an epidural 16 space-occupying lesion in the right temporoparietal region, which was assumed to be a meningioma by radiographic criteria. However, the surgical specimen was diagnosed as Ewing’s sarcoma.

Conclusion

Primary intracranial extraosseous Ewing’s sarcoma is a rare condition that may mimic a meningioma on imaging. Physicians must be cognizant of this possibility, particularly in any young individual with a solitary contrast-enhancing dural-based lesion.

Choudhury KB, Sharma S, Kothari R, Majumder A (2011) Primary extraosseous intracranial Ewing’s sarcoma: case report and literature review. Indian J Med Paediatr Oncol 32:118–121CrossRefPubMedPubMedCentral

Kumar V, Singh A, Sharma V, Kumar M (2017) Primary intracranial dural-based Ewing sarcoma/peripheral primitive neuroectodermal tumor mimicking a meningioma: a rare tumor with review of literature. Asian J Neurosurg 12(3):351–357CrossRefPubMedPubMedCentral

Singleton S, Koerner C (1991) Lenticular lesions: not always an epidural hematoma. Pediatr Emerg Care 17(4):252–254CrossRef

Mishra S, Parida D, Senapati S, Patra S. Multifocal Ewing’s sarcoma, presenting radiologically as extradural hematoma. Neurol India 2012; 60(\):361PubMed

Antunes NL, Lellouch-Tubiana A, Kalifa C, Delattre O, Pierre-Kahn A, Rosenblum MK (2001) Intracranial Ewing sarcoma/‘peripheral’ primitive neuroectodermal tumor of dural origin with molecular genetic confirmation. J Neuro-Oncol 51:51–56CrossRef

D’Antonio A, Caleo A, Garcia JF, Marsilia GM, De Dominicis G, Boscaino A (2004) Primary peripheral PNET/Ewing’s sarcoma of the dura with FISH analysis. Histopathology 45:651–654CrossRefPubMed

Dedeurwaerdere F, Giannini C, Sciot R, Rubin BP, Perilongo G, Borghi L, Ballotta ML, Cornips E, Demunter A, Maes B, Dei Tos AP (2002) Primary peripheral PNET/Ewing’s sarcoma of the dura: a clinicopathologic entity distinct from central PNET. Mod Pathol 15:673–678CrossRefPubMed

Gupta A, Bansal S, Chaturvedi S (2012) Primary Ewing’s sarcoma of frontoparietal bone with major soft tissue extension: an unusual presentation and review of the literature. Case Rep Pathol 2012:713836PubMedPubMedCentral

Katayama Y, Kimura S, Watanabe T, Yoshino A, Koshinaga M (1999) Peripheral-type primitive neuroectodermal tumor arising in the tentorium. Case report J Neurosurg 90:141–144PubMed

10.

Mellai M, Caldera V, Comino A, Fortunato M, Bernucci C, Schiffer D. (2010) PNET/ESFT of the cranial vault: a case report. Clin Neuropathol 29:372–377

11.

Mobley BC, Roulston D, Shah GV, Bijwaard KE, McKeever PE (2006) Peripheral primitive neuroectodermal tumor/Ewing’s sarcoma of the craniospinal vault: case reports and review. Hum Pathol 37:845–853CrossRefPubMed

12.

Pekala JS, Gururangan S, Provenzale JM, Mukundan S Jr (2006) Central nervous system extraosseous Ewing sarcoma: radiologic manifestations of this newly defined pathologic entity. AJNR Am J Neuroradiol 27:580–583PubMed

13.

Papotti M, Abbona G, Pagani A, Monga G, Bussolati G (1998) Primitive neuroectodermal tumor of the meninges: an histological, immuno-histochemical, ultrastructural, and cytogenetic study. Endocr Pathol 9:275–280CrossRefPubMed

14.

Stechschulte SU, Kepes JJ, Holladay FP, McKittrick RJ (1994) Primary meningeal extraosseous Ewing’s sarcoma: case report. Neurosurgery 35:143–147CrossRefPubMed

15.

Tanboon J, Sitthinamsuwan B, Paruang T, Marrano P, Thorner P (2012) Primary intracranial Ewing sarcoma with an unusually aggressive course: a case report and review of the literature. Neuropathology 32(3):293–300CrossRefPubMed

16.

Sorensen PH, Lessnickz SL, Lopez-Terrada D, Liu XF, Triche TJ, Denny CT (1994) A second Ewing's sarcoma translocation, t (21; 22), fuses the EWS gene to another ETS–family transcription factor, ERG. Natural Genetics 6(2):146

Title: Primary intracranial extraosseous Ewing’s sarcoma
Authors: Amir Humza Sohail
Mohammed Sachal
Muhammad Arslan Arif Maan
Muhammad Soban
Muhammad Salman Khan
Muhammad Ehsan Bari
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: Child's Nervous System / Issue 3/2019
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-018-3991-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Primary intracranial extraosseous Ewing’s sarcoma

Abstract

Introduction

Case Presentation

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case Presentation

Conclusion

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