An Atypical Etiology of Mediastinal Lymphadenopathy: Extraskeletal Ewing SarcomaChoukri Elm’hadi1*, Mohammed Reda Khmamouche1, Mehdi Toreis1, Meryem Zerrik2, Rachid Tanz1, Hafsa Chahdi3, Mohamed Oukabli3, Hassan Errihani4 and Mohammed Ichou1
- *Corresponding Author:
- Choukri Elm’hadi
Medical oncology department
Mohammed V military teaching hospital
hay riad, zip code 10100, Rabat, Morocco
E-mail: [email protected]
Received date:: January 31, 2016 Accepted date:: February 08, 2016 Published date:: February 10, 2016
Citation: Elm’hadi C, Khmamouche MR, Toreis M, Zerrik M, Tanz R, et al. (2016) An Atypical Etiology of Mediastinal Lymphadenopathy: Extraskeletal Ewing Sarcoma. J Integr Oncol S1:007. doi:10.4172/2329-6771.S1-007
Copyright: © 2016 Elm’hadi C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Ewing's sarcomas and peripheral primitive neuroectodermal tumors are high grade malignant neoplasms, arising from bone and soft tissues and are grouped in the Ewing family of tumors. Primary localization in the mediastinum is extremely rare and was treated in only a few case reports. Lymphatic localization has never been reported. We present a case of an extraskeletal Ewing sarcoma arising from lymphadenopathy in the hilar and anterior mediastinal regions with literature review.
Case presentation: A 24 year old man was admitted to our institution for persistent cough, nocturnal diaphoresis, and weight loss of 6 kg. The chest X-ray displayed opacity of the left hilum at polycyclic contours. Chest Computed tomography scan confirmed supradiaphragmatic lymphadenopathy in the hilar and anterior mediastinal. Biopsy was performed. Histological and immunohistochemical analysis showed small and round cells tumor with positive staining for CD99 and vimentin, and negative staining of desmine, myogénine, actine muscle lisse, Protéine S-100, Chromogranine, CD56, pancytokeratin, myeloperoxidase and TTF1. Young age, morphological and immunohistological characters argued in favor of a tumor of Ewing group .We could not perform molecular cytogenetic analysis, because of the lack of technical structure. The staging was negative for any other metastatic disease or primitive bone tumor, and final diagnosis was primary localized Ewing sarcoma in mediastinal nodes. The patient received Ewing’s sarcoma chemotherapy regimen. Complete response was achieved after six courses. Radiotherapy was prescribed, and the same chemotherapy regimen was continued totaling a period of one year. The patient was well with no evidence of local relapse or metastasis three years after diagnosis.
Conclusion: Extraskeletal Ewing sarcoma should be contemplated in the differential diagnosis of mediastinal lymphadenopathy. With multimodal treatment, the patients are potentially curable.