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1.
Cir Cir ; 78(2): 159-62, 2010.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-20478118

RESUMO

BACKGROUND: Extraosseous Ewing's sarcoma is a rare tumor of neuroectodermal origin. It presents mainly in the soft tissue of the extremities and thorax. Histologically, it is similar to Ewing's sarcoma of the bone. CLINICAL CASE: We present the case of a male who arrived at the emergency room with acute abdomen, leucocytosis and imaging techniques (abdominal ultrasound and computed tomography) suggestive of complicated diverticular disease. He was treated with emergency surgery. Intraoperative findings were an unsuspected tumor (20 x 15 x 15 cm). Treatment consisted of extirpation of the tumor, separating it from the adjacent viscera and followed by chemotherapy based on epirubicin, cyclophosphamide and vincristine for six cycles. Because the control abdominal CT demonstrated tumor activity in the retroperitoneum adjacent to the ascending colon and cecum, further resection was decided upon. CONCLUSIONS: In a review of the literature, no previous reports of extraosseous Ewing's sarcoma were found presenting as acute abdomen. Due to the rarity of this tumor, only case reports or series have been found in the literature without randomized or comparative studies. Surgery was the cornerstone of treatment, without reports of preoperative chemotherapy. If the patient's condition permits, percutaneous needle biopsy is mandatory to obtain optimum treatment as well as to improve prognosis.


Assuntos
Abdome Agudo/diagnóstico , Neoplasias Retroperitoneais/diagnóstico , Sarcoma de Ewing/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Masculino
2.
Cir. & cir ; 78(2): 163-166, mar.-abr. 2010. ilus
Artigo em Espanhol | LILACS | ID: lil-565690

RESUMO

Introducción: El sarcoma de Ewing extraóseo es un tumor raro de origen neuroectodérmico que se ha presentado principalmente en las partes blandas de las extremidades y del tórax; histológicamente es similar al sarcoma de Ewing en el tejido óseo. Caso clínico: Paciente con abdomen agudo y leucocitosis, en quien por imagen (ultrasonido y tomografía axial computarizada) se diagnosticó enfermedad diverticular complicada del colon, por lo que fue intervenido quirúrgicamente, encontrando lesión localizada en el espacio de Retzius con extensión a la cavidad abdominal de 20 x 15 x 15 cm. El tratamiento consistió en extirpación del tumor, separándolo de las vísceras adyacentes y el paciente fue tratado con quimioterapia: epirrubicina, ciclofosfamida y vincristina por seis ciclos; la tomografía abdominal de control mostró actividad tumoral en el retroperitoneo, adyacente al colon ascendente y ciego, por lo que se requirió nuevo tratamiento resectivo. Conclusiones: En la revisión de la literatura no hay informes previos de sarcoma de Ewing extraóseo cuya presentación sea abdomen agudo. Por la rareza de esta lesión, en la literatura solo hay registro de casos o algunas series de casos, por lo que no fue posible llevar a cabo comparaciones; la extirpación de la lesión es el pilar del tratamiento. No se define el papel de la quimioterapia preoperatoria. La biopsia percutánea guiada por algún método de imagen es de utilidad para otorgar al paciente un tratamiento óptimo que le permita un mejor pronóstico.


BACKGROUND: Extraosseous Ewing's sarcoma is a rare tumor of neuroectodermal origin. It presents mainly in the soft tissue of the extremities and thorax. Histologically, it is similar to Ewing's sarcoma of the bone. CLINICAL CASE: We present the case of a male who arrived at the emergency room with acute abdomen, leucocytosis and imaging techniques (abdominal ultrasound and computed tomography) suggestive of complicated diverticular disease. He was treated with emergency surgery. Intraoperative findings were an unsuspected tumor (20 x 15 x 15 cm). Treatment consisted of extirpation of the tumor, separating it from the adjacent viscera and followed by chemotherapy based on epirubicin, cyclophosphamide and vincristine for six cycles. Because the control abdominal CT demonstrated tumor activity in the retroperitoneum adjacent to the ascending colon and cecum, further resection was decided upon. CONCLUSIONS: In a review of the literature, no previous reports of extraosseous Ewing's sarcoma were found presenting as acute abdomen. Due to the rarity of this tumor, only case reports or series have been found in the literature without randomized or comparative studies. Surgery was the cornerstone of treatment, without reports of preoperative chemotherapy. If the patient's condition permits, percutaneous needle biopsy is mandatory to obtain optimum treatment as well as to improve prognosis.


Assuntos
Humanos , Masculino , Adulto , Abdome Agudo/diagnóstico , Neoplasias Retroperitoneais/diagnóstico , Sarcoma de Ewing/diagnóstico , Diagnóstico Diferencial
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