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Ewing sarcoma of the chest wall

Case contributed by Ian Bickle
Diagnosis certain

Presentation

19 year-old male with an enlarging painless right chest wall mass.

Patient Data

Age: 19
Gender: Male
x-ray

Right chest wall based mass with destruction of the right 6th rib.  The mass has a significant soft tissue element.

Large expansile destructive mass in the right 6th rib.

Both lungs contain multiple pulmonary nodules.

Ultrasound guided biopsy was performed with a 18G core biopsy needle.

pathology

H & E: Sheets of uniform small round blue cells with minimal cytoplasm.

Positive for CD99.  Cytokeratin negative.

Case Discussion

Ewings sarcoma of the chest wall as with the same tumor elsewhere are predominantly diagnosed in children and young adults.

These tumors usually arise in the osseous structures of the chest wall (ribs, scapula, sternum of clavicle).

On CT these tumors are typically ill-defined and heterogeneous attenuation due to multiple areas of cystic degeneration/necrosis.

 

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