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Journal of Medical Case Reports

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Open Access 01-12-2024 | Sarcoma | Case report

Primary extraskeletal intradural Ewing sarcoma with acute hemorrhage: a case report and review of the literature

Authors: HusamEddin Salama, Lila H. Abu-Hilal, Mayar Idkedek, Abdalwahab Kharousha, Mohand Abulihya, Hafez Nimer

Published in: Journal of Medical Case Reports | Issue 1/2024

Abstract

Background

Spinal cord tumors present a challenge in diagnosis and treatment due to their varied histopathological characteristics. While Ewing sarcoma is a rare malignant tumor typically originating from skeletal bone, cases of primary intradural extraskeletal Ewing sarcoma are exceptionally rare. The similarity of its presentation to other spinal tumors further complicates its identification and management.

Case presentation

We report a case of a 58-year-old Palestinian male with intradural extraskeletal lumbar Ewing sarcoma. The patient initially presented with lower back pain and bilateral S1 radiculopathy, with more severe symptoms on the left side. Magnetic resonance imaging revealed a 7 cm oval-shaped mass with homogeneous contrast enhancement, obstructing the spinal canal from L3/L4 to L5/S1 levels. Initially, a myxopapillary ependymoma was suspected, but the patient’s sensory and motor functions suddenly deteriorated during hospitalization. Repeat magnetic resonance imaging indicated heterogeneous contrast enhancement, indicating acute intratumoral hemorrhage. Consequently, the patient underwent emergent L3–L5 laminotomy, with successful gross total resection of the tumor. Histopathological and immunohistochemical analyses confirmed the diagnosis of intradural extraskeletal Ewing sarcoma. Adjuvant therapy was administered to minimize the risk of local recurrence or distant metastasis. A systematic review of relevant literature, along with retrospective analysis of medical records, operative reports, radiological studies, and histopathological findings of similar cases, was also conducted.

Conclusions

Intradural extraskeletal Ewing sarcoma is an infrequently encountered condition in adult patients, emphasizing the importance of considering it in the differential diagnosis of spinal tumors. Surgeons must possess a comprehensive understanding of this rare entity to ensure accurate staging and optimal management, particularly in the early stages when prompt intervention may improve prognosis.

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Title: Primary extraskeletal intradural Ewing sarcoma with acute hemorrhage: a case report and review of the literature
Authors: HusamEddin Salama
Lila H. Abu-Hilal
Mayar Idkedek
Abdalwahab Kharousha
Mohand Abulihya
Hafez Nimer
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Sarcoma
Radiotherapy
Cytostatic Therapy
Spinal Tumor
Published in: Journal of Medical Case Reports / Issue 1/2024
Electronic ISSN: 1752-1947
DOI: https://doi.org/10.1186/s13256-024-04384-8

At a glance: The STEP trials

Springer Medicine

Primary extraskeletal intradural Ewing sarcoma with acute hemorrhage: a case report and review of the literature

Abstract

Background

Case presentation

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Case presentation

Conclusions

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