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Year : 2000  |  Volume : 10  |  Issue : 1  |  Page : 46-47
Ewing's sarcoma of the spine


Department of Radiology, Pt. B.D.S PGIMS, Rohtak, Haryana, India

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How to cite this article:
Magu S, Mishra DS, Yadav R, Popli P, Sharma N. Ewing's sarcoma of the spine. Indian J Radiol Imaging 2000;10:46-7

How to cite this URL:
Magu S, Mishra DS, Yadav R, Popli P, Sharma N. Ewing's sarcoma of the spine. Indian J Radiol Imaging [serial online] 2000 [cited 2019 Sep 21];10:46-7. Available from: http://www.ijri.org/text.asp?2000/10/1/46/30637
Sir,

We would like to report a case of a Ewing's sarcoma of the first lumbar vertebra in an eighteen-year old male who presented with pain in the abdomen for three months and pain in the lower back for one month with no neurological deficit. A hard lump 8.0x6.0 cm was palpable in the right hypochondrium, fixed to the underlying structures and not moving with respiration.

The plain radiograph of the abdomen was essentially normal. Ultrasound of the abdomen revealed a mass of mixed echogenicity, measuring 7.0x5.0 cm in the retroperitoneum on the right, anterior to the vertebrae in the upper abdomen. A CT of the abdomen [Figure - 1] showed a large soft tissue mass anterior to the upper lumbar spine on the right with areas of calcification. Erosion of the anterior surface of the body of the first lumbar vertebra was seen. Contrast enhanced CT showed marginal enhancement of the soft tissue with central necrotic areas. Peroperative biopsy revealed a Ewing's sarcoma (ES).

Ewing's sarcoma is usually seen in the age group of 5-30 years with a peak incidence at 10-15 years. The male to female ratio is 3:2. Although it can involve any bone, it is more common in the bones of the lower extremity [1]. In the vertebral column, sacral involvement dominates followed by the lumbar, thoracic, cervical and coccygeal regions in order of decreasing frequency [2]. The dorsal vertebrae are involved in 1% of cases [3]. The vertebral body is affected primarily, although the neoplasm not infrequently extends from this region to the posterior osseous elements [4]. Ewing's sarcoma in a vertebral body leads to bone destruction, which may be followed by fracture and collapse (vertebra plana). Less frequently, osteosclerosis of a vertebral body, pedicle or other posterior osseous elements, is observed. Extension of the process into the paraspinal and intraspinal tissues is well described. There may be extension to an adjacent vertebral body with loss of height of the intervening intervertebral disc and spread to the pedicles, laminae and transverse and spinous processes. Calcification in the soft tissue is a comparatively rare manifestation (9%). The differential diagnosis of Ewing's sarcoma in the vertebral column includes pyogenic or tuberculous osteomyelitis, lymphoma, leukemia, histiocytosis and metastatic disease [2].

 
   References Top

1.Eggli KD, Quiogue T and Moser RP. Ewing's Sarcoma. RCNA 1993; 31: 325-37.  Back to cited text no. 1    
2.Resnik D, Kyriakas M, Greenway GD: Tumour and Tumour like lesions of bone, imaging and pathology of specific lesions. In Resnik D (Ed.) Diagnosis of bone and joint disorders, 3rd ed. Philadelphia, WB Saunders Company, 1995: 3885-7.  Back to cited text no. 2    
3.Greenfield GB: Primary malignant tumours of bone. In: Greenfield GB Radiology of bone diseases, 4th ed. Philadelphia J.B. Lippincott Company, 597-603.  Back to cited text no. 3    
4.Wooken WB, Summer TE, Crowe JE et al . Case report 64. Skel Radiol 1978; 3: 65.  Back to cited text no. 4    

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Correspondence Address:
Sarita Magu
Department of Radiology, Pt. B.D.S PGIMS, Rohtak, Haryana
India
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Source of Support: None, Conflict of Interest: None


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