ABSTRACT
OBJECTIVES: To review the cases of Ewing's sarcoma (ES) diagnosed in children at our hospital from 1995 to 2005 and to analyze uncommon imaging signs at diagnosis or during the course of the disease. MATERIAL AND METHODS: We reviewed the cases of 21 patients with ES (12 boys and 9 girls) diagnosed between the ages of 2 and 14 years. We analyzed the types of presentation, the imaging findings (plain-films, CT, and MRI), and the patients' evolution. All cases were confirmed at histological study. RESULTS: The following uncommon manifestations were found in 11 patients: 2 vertebral, one cervical, and one dorsal ES that initially manifested as spinal cord compression and as a mediastinal mass, respectively; 2 sacral ES with ascending epidural masses; 1 mandibular ES; 1 costal ES with hemorrhagic cerebral metastases; 3 extraskeletal (thigh, buttocks, and pelvis minor) ES with bone metastases at diagnosis: the first two had spinal cord and nerve compression due to vertebral metastases; 2 ES had benign-appearing radiological findings (cortical lesion of the radius with osseous remodeling of the ulna and an expanding multilocular lesion of the fibula). CONCLUSIONS: Although ES is the second most common malignant bone tumor in children, its unusual imaging findings are less well known. More than half (52.4 %) of our last 21 patients presented some of these manifestations at diagnosis or during follow-up, so radiologists should be aware of them and include ES in the prebiopsy diagnostic possibilities.
Subject(s)
Bone Neoplasms/diagnosis , Magnetic Resonance Imaging , Sarcoma, Ewing/diagnosis , Tomography, X-Ray Computed , Adolescent , Child , Child, Preschool , Female , Humans , Male , Retrospective StudiesABSTRACT
Objetivos: revisión de los sarcomas de Ewing (SE) infantiles diagnosticados desde 1995 hasta el 2005 en nuestro hospital, analizando las manifestaciones infrecuentes en el momento del diagnóstico o en su evolución. Material y métodos: estudio retrospectivo de 21 pacientes con SE (12 varones y 9 mujeres) diagnosticados entre los 2 y 14 años. Análisis de sus formas de presentación, hallazgos radiológicos (radiografía, tomografía computarizada y resonancia magnética) y evolución. Todos los casos tienen confirmación anatomopatológica. Resultados: 11 pacientes tuvieron las manifestaciones infrecuentes siguientes: 2 SE vertebrales, 1 cervical y 1 dorsal que se iniciaron con compresión medular y masa mediastínica, respectivamente; 2 SE sacros con masa epidural ascendente; 1 SE de localización mandibular; 1 SE costal con metástasis cerebral hemorrágica; 3 SE extraesqueléticos (muslo, glúteo y pelvis menor) con metástasis óseas al diagnóstico, los 2 primeros con compresión medular y radicular por metástasis vertebrales; 2 SE con manifestaciones radiológicas de benignidad (lesión cortical del radio incurvando al cúbito y aspecto insuflante multiloculado del peroné). Conclusiones: aunque el SE es el segundo tumor óseo maligno más frecuente de la infancia, sus manifestaciones infrecuentes son menos conocidas. Más de la mitad (52,4 %) de nuestros últimos 21 casos han presentado alguna de estas manifestaciones al diagnóstico o en su evolución, que deben conocerse para incluir al SE como posibilidad diagnóstica prebiopsia (AU)
Objectives: to review the cases of Ewing's sarcoma (ES) diagnosed in children at our hospital from 1995 to 2005 and to analyze uncommon imaging signs at diagnosis or during the course of the disease. Material and methods: we reviewed the cases of 21 patients with ES (12 boys and 9 girls) diagnosed between the ages of 2 and 14 years. We analyzed the types of presentation, the imaging findings (plain-films, CT, and MRI), and the patients' evolution. All cases were confirmed at histological study. Results: the following uncommon manifestations were found in 11 patients: 2 vertebral, one cervical, and one dorsal ES that initially manifested as spinal cord compression and as a mediastinal mass, respectively; 2 sacral ES with ascending epidural masses; 1 mandibular ES; 1 costal ES with hemorrhagic cerebral metastases; 3 extraskeletal (thigh, buttocks, and pelvis minor) ES with bone metastases at diagnosis: the first two had spinal cord and nerve compression due to vertebral metastases; 2 ES had benign-appearing radiological findings (cortical lesion of the radius with osseous remodeling of the ulna and an expanding multilocular lesion of the fibula). Conclusions: although ES is the second most common malignant bone tumor in children, its unusual imaging findings are less well known. More than half (52.4 %) of our last 21 patients presented some of these manifestations at diagnosis or during follow-up, so radiologists should be aware of them and include ES in the prebiopsy diagnostic possibilities (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Sarcoma, Ewing , /epidemiology , Retrospective Studies , Neoplasm MetastasisABSTRACT
Severe unilateral varus deformity of the distal end of the femur secondary to a focal fibrous lesion is reported. It is a malformative process rare at this level, this being the first report of it in the radiological literature. The conventional radiograph is pathognomonic and CT is useful in the confirmation of the fibrous tissue. Osteotomy is indicated only if the deformity progresses or the angle of varus is severe.
