Solitary extra-skeletal sinonasal metastasis from a primary skeletal Ewing's sarcoma

Hayes, S.M., Jani, T.N., Rahman, S.M., Jogai, S., Harries, P.G. and Salib, R.J. (2011) Solitary extra-skeletal sinonasal metastasis from a primary skeletal Ewing's sarcoma Journal of Laryngology & Otology, 125, (8), pp. 861-864. (doi:10.1017/S0022215111000764). (PMID:21729453).


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Introduction: Ewing's sarcoma is a rare, malignant tumour predominantly affecting young adolescent males. We describe a unique case of an isolated extra-skeletal metastasis from a skeletal Ewing's sarcoma primary, arising in the right sinonasal cavity of a young man who presented with severe epistaxis and periorbital cellulitis.

Results: Histologically, the lesion comprised closely packed, slightly diffuse, atypical cells with round, hyperchromatic nuclei, scant cytoplasm and occasional mitotic figures, arranged in a sheet-like pattern. Immunohistochemical analysis showed positive staining only for cluster of differentiation 99 glycoprotein. Fluorescent in situ hybridisation identified the Ewing's sarcoma gene, confirming the diagnosis.
Management: Complete surgical resection was achieved via a minimally invasive endoscopic transnasal approach; post-operative radiotherapy. Ten months post-operatively, there were no endoscopic or radiological signs of disease.

Conclusion: Metastatic Ewing's sarcoma within the head and neck is incredibly rare and can pose significant diagnostic and therapeutic challenges. An awareness of different clinical presentations and distinct histopathological features is important to enable early diagnosis. This case illustrates one potential management strategy, and reinforces the evolving role of endoscopic transnasal approaches in managing sinonasal cavity and anterior skull base tumours.

Item Type: Article
Digital Object Identifier (DOI): doi:10.1017/S0022215111000764
Keywords: sarcoma, ewing's, neuroectodermal tumours, diagnosis, neoplasm metastasis, pathology, radiology, therapeutics

Organisations: Clinical & Experimental Sciences
ePrint ID: 195695
Date :
Date Event
August 2011Published
Date Deposited: 25 Aug 2011 11:20
Last Modified: 18 Apr 2017 01:37
Further Information:Google Scholar

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