Beyond the Bones: A Case Report of Extraosseous Ewing Sarcoma.

Ewing sarcoma (ES) is primarily recognized as a primary bone tumor; however, its extraosseous variant is exceptionally rare and presents unique clinical challenges. In this article, we report the case of a 22-year-old male who initially presented with abdominal swelling. Diagnostic tests included abdominal imaging and a CT scan, revealing a solid liver mass. A thorough evaluation confirmed it to be an extraosseous ES, supported by liver biopsy and immunohistochemistry demonstrating positive expression for AE1/AE3 and CD-99, along with genetic analysis revealing a rearrangement of the EWSR1 gene (translocation 22q12). The patient's treatment involved a multimodal approach, including perioperative chemotherapy, surgery, and postoperative chemotherapy, following which the patient remained in complete remission after 24 months. This case emphasizes the importance of considering rare malignancies such as ES in differential diagnoses for young patients with liver masses. It also accentuates the pivotal role of family physicians in early detection and holistic patient care, underscoring the need for comprehensive investigations when encountering persistent symptoms.

Optimising patient safety using pharmaceutical intervention in domiciliary hospitalization.

Introduction The domiciliary hospitalization unit (DHU) is an innovative model of care provision, where hospital care is transferred to the patients' home. However, this shift adds a care transition layer to the process, which may increase the probability of medication errors to occur. Method A pharmacist has been integrated into the DHU team to improve medication use. We developed an observational study documenting his intervention for 6 months. Information about the patient's drug therapy before admission, during hospitalization and after hospital discharge were gathered, enabling comparison of possible discrepancies that may happen during care transitions. The pharmacist evaluated the appropriateness, necessity, effectiveness, and safety of medication and intervened when deemed appropriate. Conclusions Data suggests that a pharmacist involved in the DHU may have a positive impact on medication use. Medication review and reconciliation are examples of pharmaceutical interventions that may lead to increased effectiveness and patient safety.