Ewing's sarcoma of the tibia

Case contributed by Dr Domenico Nicoletti

Presentation

Young dancer with knee pain for about three months.

Patient Data

Age: 14 years
Gender: Female
X-ray

Right knee

In the lateral projection in the proximal diaphysis of the tibia, there is an oval-shaped lytic lesion, with a shaded transition zone (2 centimeters length).

The patient returns after three years without having done any therapy or further assessment, with pain and swelling of the knee.

CT

Right knee

Large osteolysis of the proximal tibial metadiaphysis that arise in medullary cavity with extensive permeative lesion of the medial cortex and modest extraosseus component.
There is no periosteal reaction. The transition zone is poorly defined.

CT

Guided biopsy

Guided CT biopsy of the lesion.

Pathology

Histological report

Case Discussion

Ewing sarcoma involves long bones presenting as a permeative pattern of bone destruction. Periosteal reaction is common. Commonly involves metadiaphysis of long bones. CT to evaluate bone destruction and extra-osseous involvement while MRI is method of choice for tumor staging for assessment of soft tissue involvement.

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Case information

rID: 74269
Published: 13th Feb 2020
Last edited: 13th Feb 2020
Inclusion in quiz mode: Included

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