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Extraskeletal Ewing's Sarcoma Arising from the Sciatic Nerve: A Diagnostic Challenge.

Sharma A, Brown K, Skinner J, Whelan J, Fox M - Case Rep Surg (2015)

Bottom Line: Due to the morbidity of nerve resection, radiotherapy and chemotherapy were commenced.In this case there were subtle signs of a malignant process in the form of unremitting pain.It is vital to keep in mind the less common tumours that can affect the peripheral nervous system in such cases.

View Article: PubMed Central - PubMed

Affiliation: Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, UK.

ABSTRACT
Ewing's sarcoma is a common bone tumour of childhood but is a rare occurrence in individuals over 20 years of age. Few cases are reported as originating from peripheral nerves. We present an unusual case of extraosseous Ewing's sarcoma originating from the sciatic nerve in a 66-year-old patient which had the clinical hallmarks of a benign nerve sheath tumour. Following discussion at a multidisciplinary meeting, excision biopsy of the suspected benign nerve sheath tumour was planned. At operation, the mass had malignant features. Histology confirmed the presence of Ewing's sarcoma. Due to the morbidity of nerve resection, radiotherapy and chemotherapy were commenced. Ewing's sarcoma is known to mimic benign pathologies. In this case there were subtle signs of a malignant process in the form of unremitting pain. It is vital to keep in mind the less common tumours that can affect the peripheral nervous system in such cases.

No MeSH data available.


Related in: MedlinePlus

Intraoperative photo of Ewing's sarcoma arising from the tibial segment of the right sciatic nerve (controlled with slings) in the mid-thigh. The areas of necrosis as well as the irregular shape of the lesion clearly differentiate it from the appearances of a schwannoma.
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fig2: Intraoperative photo of Ewing's sarcoma arising from the tibial segment of the right sciatic nerve (controlled with slings) in the mid-thigh. The areas of necrosis as well as the irregular shape of the lesion clearly differentiate it from the appearances of a schwannoma.

Mentions: Intraoperative appearances were of a hard tumour with poorly defined borders that was infiltrative into the fascicles of the tibial component of the sciatic nerve. These are appearances more consistent with those of a malignant lesion (Figure 2). Therefore the opinion of a specialist sarcoma surgeon was sought intraoperatively. Rather than to proceed with excision, a wedge biopsy was performed and samples were sent for histological analysis.


Extraskeletal Ewing's Sarcoma Arising from the Sciatic Nerve: A Diagnostic Challenge.

Sharma A, Brown K, Skinner J, Whelan J, Fox M - Case Rep Surg (2015)

Intraoperative photo of Ewing's sarcoma arising from the tibial segment of the right sciatic nerve (controlled with slings) in the mid-thigh. The areas of necrosis as well as the irregular shape of the lesion clearly differentiate it from the appearances of a schwannoma.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4510112&req=5

fig2: Intraoperative photo of Ewing's sarcoma arising from the tibial segment of the right sciatic nerve (controlled with slings) in the mid-thigh. The areas of necrosis as well as the irregular shape of the lesion clearly differentiate it from the appearances of a schwannoma.
Mentions: Intraoperative appearances were of a hard tumour with poorly defined borders that was infiltrative into the fascicles of the tibial component of the sciatic nerve. These are appearances more consistent with those of a malignant lesion (Figure 2). Therefore the opinion of a specialist sarcoma surgeon was sought intraoperatively. Rather than to proceed with excision, a wedge biopsy was performed and samples were sent for histological analysis.

Bottom Line: Due to the morbidity of nerve resection, radiotherapy and chemotherapy were commenced.In this case there were subtle signs of a malignant process in the form of unremitting pain.It is vital to keep in mind the less common tumours that can affect the peripheral nervous system in such cases.

View Article: PubMed Central - PubMed

Affiliation: Peripheral Nerve Injury Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex HA7 4LP, UK.

ABSTRACT
Ewing's sarcoma is a common bone tumour of childhood but is a rare occurrence in individuals over 20 years of age. Few cases are reported as originating from peripheral nerves. We present an unusual case of extraosseous Ewing's sarcoma originating from the sciatic nerve in a 66-year-old patient which had the clinical hallmarks of a benign nerve sheath tumour. Following discussion at a multidisciplinary meeting, excision biopsy of the suspected benign nerve sheath tumour was planned. At operation, the mass had malignant features. Histology confirmed the presence of Ewing's sarcoma. Due to the morbidity of nerve resection, radiotherapy and chemotherapy were commenced. Ewing's sarcoma is known to mimic benign pathologies. In this case there were subtle signs of a malignant process in the form of unremitting pain. It is vital to keep in mind the less common tumours that can affect the peripheral nervous system in such cases.

No MeSH data available.


Related in: MedlinePlus