Ewing sarcoma of the thumb presenting in a Hispanic patient: A case report.

Abstract

Introduction: Ewing sarcoma (EwS) is an uncommon and highly aggressive cancer primarily affecting children and young adults. This tumor constitutes 10 % to 15 % of all bone sarcomas and often presents in the pelvis, axial skeleton, and femur. Despite its rarity, EwS's rapid progression and early metastatic potential make it a significant concern in pediatric oncology, highlighting the need for effective treatment protocols and further research.

Case presentation: We report the case of an 18-year-old Hispanic male who presented with an initially asymptomatic growing mass in his right distal left thumb. The diagnosis of an extra-axial EwS was confirmed after histopathologic evaluation. He was managed with a trans-interphalangeal disarticulation followed by adjuvant chemotherapy with no signs of recurrence at 24-months. This case has been reported in line with the SURGICAL CASE Reports (SCARE) guidelines.

Discussion: EwS is known for rapid growth and early metastasis, often remaining asymptomatic until advanced stages, complicating treatment and reducing survival. Common symptoms include tenderness and swelling. In our case, the patient presented with a slowly enlarging, initially asymptomatic thumb mass, leading to delayed diagnosis. EwS in the hand, especially the thumb, is rare, with only nine cases reported.

Conclusion: While EwS rarely manifests in fingers, it remains crucial to include this diagnosis and other malignant tumors as a potential consideration when evaluating lesions found in this area.