Subject(s)
Flavobacteriaceae Infections/diagnosis , Flavobacteriaceae/isolation & purification , Sarcoma, Ewing/diagnosis , Adolescent , Antineoplastic Agents/therapeutic use , Flavobacteriaceae/genetics , Flavobacteriaceae Infections/complications , Flavobacteriaceae Infections/microbiology , Humans , Male , RNA, Ribosomal, 16S/chemistry , RNA, Ribosomal, 16S/genetics , RNA, Ribosomal, 16S/metabolism , Sarcoma, Ewing/complications , Sarcoma, Ewing/drug therapy , Sarcoma, Ewing/microbiology , Sequence Analysis, DNASubject(s)
Antifungal Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Hyphae/drug effects , Immunocompromised Host , Pythiosis/microbiology , Pythium/drug effects , Thigh/microbiology , Antifungal Agents/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/administration & dosage , Antineoplastic Combined Chemotherapy Protocols/immunology , Bone Neoplasms/drug therapy , Bone Neoplasms/immunology , Bone Neoplasms/microbiology , Bone Neoplasms/pathology , Child , Humans , Hyphae/physiology , Lung Neoplasms/drug therapy , Lung Neoplasms/immunology , Lung Neoplasms/microbiology , Lung Neoplasms/secondary , Male , Pyrimidines/administration & dosage , Pyrimidines/therapeutic use , Pythiosis/diagnosis , Pythiosis/drug therapy , Pythiosis/immunology , Pythium/physiology , Sarcoma, Ewing/drug therapy , Sarcoma, Ewing/immunology , Sarcoma, Ewing/microbiology , Sarcoma, Ewing/pathology , Thigh/pathology , Triazoles/administration & dosage , Triazoles/therapeutic use , VoriconazoleABSTRACT
INTRODUCTION: Ewing's sarcoma is a relatively rare osseous malignant tumour. The age of onset is generally in the youth. Epidural localisation of the malignant osseous tumour Ewing's sarcoma is exceptional. Only 29 cases were reported in surgical literature including only one infected case. OBSERVATION: We report a case of a 24 years old patient who displayed a complete flaccid tétraplégia with T1 sensitive level. Spinal cord MRI documented a cervical posterior epidural process with peripheric gadolinium enhancement. Patient was operated in emergency. A C6 and C7 laminectomy allowed complete tumour resection with its purulent intratumoural collection revealed during the operation. A total tumour removal was performed. The immediate postsurgical evolution was remarkable, with a quasi complete recovery in the upper limbs. DISCUSSION: Firstly described by James Ewing in 1921, the spinal epidural locations of the Ewing's sarcoma are rare without specific clinical signs generally presenting as a radiculo-medullary compression. Our case is the second infected epidural Ewing sarcoma reported in the literature. However the cause remains unexplained. For this spinal epidural extraosseous tumour, X-ray radiography failed to show any osseous lesions. On MRI, the usually found aspect is a T1 and T2 isosignal with gadolinium enhancement. CONCLUSION: Through our observation, we underlined the scarcity of this pathology in the cervical epidural localization and the association with infection. We also emphasized on the complete removal, in order to give the best functional and vital outcome.
Subject(s)
Epidural Neoplasms/diagnosis , Magnetic Resonance Imaging , Sarcoma, Ewing/diagnosis , Adult , Cervical Vertebrae , Contrast Media , Diagnosis, Differential , Epidural Neoplasms/microbiology , Epidural Neoplasms/surgery , Gadolinium DTPA , Humans , Sarcoma, Ewing/microbiology , Sarcoma, Ewing/surgeryABSTRACT
Rhodotorula sp. are commensal yeasts that may cause opportunistic infections. There have been only a few case reports of Rhodotorula fungemia in children with cancer, and in all of them the patients had a central venous catheter inserted. The authors report three nonfatal cases of fungemia by Rhodotorula in patients with post-chemotherapy neutropenia. Two of three patients required catheter removal, and a response was achieved with systemic antifungal therapy. Aggressive therapy may be required for selected high-risk patients.
Subject(s)
Antifungal Agents/therapeutic use , Fungemia/etiology , Rhodotorula/isolation & purification , Adolescent , Antineoplastic Agents/therapeutic use , Catheterization, Central Venous/adverse effects , Catheters, Indwelling/microbiology , Child , Female , Fungemia/drug therapy , Humans , Leukemia, Promyelocytic, Acute/complications , Leukemia, Promyelocytic, Acute/drug therapy , Leukemia, Promyelocytic, Acute/microbiology , Lymphoma, T-Cell/complications , Lymphoma, T-Cell/drug therapy , Lymphoma, T-Cell/microbiology , Sarcoma, Ewing/complications , Sarcoma, Ewing/drug therapy , Sarcoma, Ewing/microbiologyABSTRACT
An unusual case of extradural, intraspinal Ewing's sarcoma with significant extraspinal extension is reported. In view of associated constitutional symptoms, suggestive signs, leucocytosis, elevated ESR and operative findings, the initial diagnosis of Pott's spine was entertained. The lesion however turned out to be infected Ewing's sarcoma on histopathology and bacteriological examination.
