Rare Extraskeletal Ewing Sarcoma of the Anterior Abdominal Wall: A Diagnostic Challenge.

IF 0.7 Q4 ONCOLOGY

Case Reports in Oncology Pub Date : 2025-07-07 eCollection Date: 2025-01-01 DOI:10.1159/000547251

Saurabh Raj, Debanjan Nandi, Rudrakshi Mahaldar

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Abstract

Introduction: Ewing sarcoma (ES) is a highly malignant neoplasm, typically arising from bone in children and young adults. Extraskeletal Ewing sarcoma (EES), involving soft tissues without bone involvement, represents a small fraction of ES cases. Even rarer is its manifestation in the anterior abdominal wall.

Case presentation: We report a case of a 27-year-old male presenting with right iliac fossa pain and a palpable mass, ultimately diagnosed as EES of the anterior abdominal wall. Radiological imaging revealed a soft tissue tumour within the rectus sheath with evidence of pulmonary metastasis. Histopathological analysis revealed small round blue cells, and immunohistochemistry demonstrated strong positivity for CD99, FLI1, WT1, and synaptophysin, confirming the diagnosis. Treatment was initiated with multi-agent chemotherapy and radiotherapy, and the patient remains under ongoing follow-up.

Conclusion: This case underscores the diagnostic challenge EES poses in atypical locations, requiring a high index of suspicion and a multimodal diagnostic and therapeutic approach.

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罕见的前腹壁骨外尤文氏肉瘤：诊断上的挑战。

简介：尤文氏肉瘤（ES）是一种高度恶性肿瘤，通常发生于儿童和年轻人的骨骼。骨骼外尤文氏肉瘤（EES），累及软组织而不累及骨骼，占ES病例的一小部分。在前腹壁的表现更为罕见。病例介绍：我们报告一个27岁的男性病例，表现为右髂窝疼痛和可触及的肿块，最终诊断为前腹壁EES。放射影像显示一软组织肿瘤在直肌鞘内，并有肺转移的证据。组织病理学分析显示小而圆的蓝色细胞，免疫组织化学显示CD99、FLI1、WT1和synaptophysin强烈阳性，证实诊断。治疗开始于多药化疗和放疗，患者仍在持续随访中。结论：该病例强调了EES在非典型部位的诊断挑战，需要高怀疑指数和多模式诊断和治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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