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Ewing Sarcoma chest wall

Alcaraz EMA - MedPix (2007)

View Article: MedPix Image - MedPix Case

Affiliation: Affiliation Unlisted - Please See Comments

ABSTRACT

Diagnosis: Ewing Sarcoma chest wall

History: A 14 year old boy presented with a complaint of right arm and shoulder pain over the last week, as well as right sided chest pain. His symptoms had been worsening over the previous 2-3 days, without any resolution of the pain with motrin or naproxen. Of significance, he had been participating in archery recently during gym class, using his right arm to draw back the bow. There are no known relieving factors, but his pain is worsened mostly when lying down. Overall, review of systems was negative for fevers, shortness of breath, cough, congestion, or any other constitutional symptoms. He does have a past history of rheumatoid arthritis and ulcerative colitis.

Findings: • Images 1a,b: AP and Lateral CXR = Large pleural based chest wall mass in the right upper hemithorax. Moderately large right pleural effusion. • Image 2: Bone scan whole body = Normal bone scan. Normal uptake in the physes. Normal axial and appendicular skeleton. No abnormal soft tissue uptake. No increased activity in the right second right on whole-body images. • Image 3: CT chest/abdomen with contrast = Large heterogeneous soft tissue mass involving the anterior chest wall with destruction of the second right anterior rib. Moderate right pleural effusion with right lower lobe atelectasis.

Ddx: • Tumor (lymphoma, osteosarcoma, histiocytoma, leukemia, chondrosarcoma, medulloblastoma, rhabdomyosarcoma, giant cell) • Langerhan Histiocytosis X • Infection - subacute osteomyelitis

Dxhow: Biopsy

Exam: General: alert and oriented x 3, non-toxic Neck: supple, without lymphadenopathy Heart: RRR, no extra heart sounds Lungs: clear to auscultation bilaterally, good aeration Chest: reproducible pain with palpation of lower costal border, pain also below right clavicular area Ext: full range of motion in right arm and shoulder, without pain

No MeSH data available.


This is the same bone scan image - but photographically inverted.
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MPX2132_synpic34491: This is the same bone scan image - but photographically inverted.


Ewing Sarcoma chest wall

Alcaraz EMA - MedPix (2007)

This is the same bone scan image - but photographically inverted.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2132&req=5

MPX2132_synpic34491: This is the same bone scan image - but photographically inverted.

View Article: MedPix Image - MedPix Case

Affiliation: Affiliation Unlisted - Please See Comments

ABSTRACT

Diagnosis: Ewing Sarcoma chest wall

History: A 14 year old boy presented with a complaint of right arm and shoulder pain over the last week, as well as right sided chest pain. His symptoms had been worsening over the previous 2-3 days, without any resolution of the pain with motrin or naproxen. Of significance, he had been participating in archery recently during gym class, using his right arm to draw back the bow. There are no known relieving factors, but his pain is worsened mostly when lying down. Overall, review of systems was negative for fevers, shortness of breath, cough, congestion, or any other constitutional symptoms. He does have a past history of rheumatoid arthritis and ulcerative colitis.

Findings: • Images 1a,b: AP and Lateral CXR = Large pleural based chest wall mass in the right upper hemithorax. Moderately large right pleural effusion. • Image 2: Bone scan whole body = Normal bone scan. Normal uptake in the physes. Normal axial and appendicular skeleton. No abnormal soft tissue uptake. No increased activity in the right second right on whole-body images. • Image 3: CT chest/abdomen with contrast = Large heterogeneous soft tissue mass involving the anterior chest wall with destruction of the second right anterior rib. Moderate right pleural effusion with right lower lobe atelectasis.

Ddx: • Tumor (lymphoma, osteosarcoma, histiocytoma, leukemia, chondrosarcoma, medulloblastoma, rhabdomyosarcoma, giant cell) • Langerhan Histiocytosis X • Infection - subacute osteomyelitis

Dxhow: Biopsy

Exam: General: alert and oriented x 3, non-toxic Neck: supple, without lymphadenopathy Heart: RRR, no extra heart sounds Lungs: clear to auscultation bilaterally, good aeration Chest: reproducible pain with palpation of lower costal border, pain also below right clavicular area Ext: full range of motion in right arm and shoulder, without pain

No MeSH data available.