Indian Journal of Radiology Indian Journal of Radiology  

   Login   | Users online: 193

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size     

 

LETTER TO EDITOR Table of Contents   
Year : 2003  |  Volume : 13  |  Issue : 2  |  Page : 235-236
Ewings sarcoma of distal radius : Unusual presentation


Govt. Medical College, Nagpur, India

Click here for correspondence address and email
 

How to cite this article:
Taori K B, Parate R, Ingole S U. Ewings sarcoma of distal radius : Unusual presentation. Indian J Radiol Imaging 2003;13:235-6

How to cite this URL:
Taori K B, Parate R, Ingole S U. Ewings sarcoma of distal radius : Unusual presentation. Indian J Radiol Imaging [serial online] 2003 [cited 2019 Jul 22];13:235-6. Available from: http://www.ijri.org/text.asp?2003/13/2/235/28669
Sir,

We would like to Report a case of Ewings sarcoma that presented at an unusual site in the distal end of radius.

A thirteen year old boy presented with gradually increasing painful swelling of the right distal forearm since 6 months. There was history of fever without discharging sinuses. A provisional clinical diagnosis of Osteomyelitis was entertained and the radiograph of the part was advised.

Radiograph [Figure - 1][Figure - 2] revealed an ill defined permeative pattern with mild sclerosis involving the metadiaphyseal aspect of distal radius with a wide zone of transition. Associated thin lamellar periosteal reaction proximally and thick complete periosteal reaction was noted distally with scalloping of the underlying cortex. A soft tissue component was noted around the lesion causing scalloping of the lateral aspect of distal Ulna. Radiograph of Chest frontal view [Figure - 3] revealed a solitary nodule in right lower zone. Radiological diagnosis was Ewings Sarcoma with metastasis to lung. Fine needle aspiration cytology from the lesion in forearm showed abundant round cells [Figure - 4]. Periodic acid-Schiff(PAS) was positive. The patient was managed on usual line with curative radiotherapy and chemotherapy.

Ewings sarcoma is common in both tubular and flat bones. The incidence in the distal radius is unusual and is reported to be only two percent by Dahlin et al and Kissan et al ,both of whom have studied a large series of Ewings sarcoma (1 and 2).

Radiological features show wide variation (3 and 4)from permeative pattern in the shaft of long bones to increased density in 15 % cases and invasion into soft tissues with preservation of soft tissue plains. Periosteal reaction may be Lamellated or may give an 'hair on end' appearance. Cortical destruction with saucerisation may be seen.

The initial lesions tend to infiltrate quickly to metastatise early to remainder of the skeleton, particularly to haemopoietic areas and also to lungs [5]. It can be confused with osteomyelitis, lytic osteosarcoma, secondary neuroblastoma and primary lymphoma in patient above thirty years of age.[5]

 
   References Top

1.Kissane J M, Askin FB, Foulkes, et al:Ewings Sarcoma of bone:Clinicopathological aspects of 303 cases from intergroup Ewings Sarcoma study. Hum Pathol 14:773-779,1983  Back to cited text no. 1    
2.Dahlin DC, conventry MP , Scanlon PW : Ewings Sarcoma : A critical analysis of 165 cases . J.Bone and joint surgery (Am) 43 : 185-192 ,1961  Back to cited text no. 2    
3.Vohra V G 1967Roentgen manifestations in Ewings sarcoma :a study of 156 cases. Cancer 20:727-733  Back to cited text no. 3    
4.Eggli KD, Quique T , Moser RP 1993 Ewings sarcoma. Radiol clin of North America 8:869 -881  Back to cited text no. 4    
5.Murray RO, Jacobson H G, Stoker DJ 1989 The Radiology of Skeletal Disorders.3rd edn. Churchill Livingstone, Edinburgh  Back to cited text no. 5    

Top
Correspondence Address:
K B Taori
Govt. Medical College, Nagpur
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions


    Figures

[Figure - 1], [Figure - 2], [Figure - 3], [Figure - 4]



 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *
* Registration required (free)  


    References
    Article Figures

 Article Access Statistics
    Viewed2506    
    Printed79    
    Emailed0    
    PDF Downloaded0    
    Comments [Add]    

Recommend this journal