21 y/o man with history of Ewing’s sarcoma present headache, Right sided ptosis and mydriasis and oropharyngeal dysphagia

 

Images

Doctor's Information

Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : abed mehrvar

 

Case Section

Head & Neck Imaging

 

Patient's Information

Gender : Male
Age : 21

 

Clinical Summary

21 y/o man with history of Ewing’s sarcoma present headache, Right sided ptosis and mydriasis and oropharyngeal dysphagia.

 

Imaging Findings

CT scan demonstrate soft tissue masss in Rt nasopharynx with bone destruction in clivus and petrous and encasement of C2 part of ICA and extention to jugular foramen MRI and MRV: partial visualization of right sigmoid sinus with non visualized Rt jugular vein due to tumor invasion and thrombosis

 

Differential Diagnosis

---------------------

 

Final Diagnosis

Metastatic Ewing sarcoma & Sinus thrombosis

 

Discussion (Related Text)

Ewing sarcoma is the second most common highly malignant primary bone tumour of childhood after osteosarcoma, typically arising from medullary cavity with invasion of Haversian system. They usually present as moth-eaten destructive permeative lucent lesions in the shaft of long bones with large soft tissue component without osteoid matrix, and typical onion skin periostitis Prognosis is significantly impacted by the presence of distant metastases at the time of diagnosis, which are far more common for the pelvis (25-30%) compared to extremities (<10%) 5. metastases most frequently go to bone or lungs. the skull base and nasopharyngeal metastasis is rare.

 

References

1. Burchill SA. Ewing's sarcoma: diagnostic, prognostic, and therapeutic implications of molecular abnormalities. J. Clin. Pathol. 2003;56 (2): 96-102. J. Clin. Pathol. (link) - Free text at pubmed - Pubmed citation
2. Stark P, Eber CD, Jacobson F. Primary intrathoracic malignant mesenchymal tumors: pictorial essay. J Thorac Imaging. 1994;9 (3): 148-55. Pubmed citation
3. Litzky LA. Pulmonary sarcomatous tumors. Arch. Pathol. Lab. Med. 2008;132 (7): 1104-17. doi:10.1043/1543-2165(2008)132[1104:PST]2.0.CO;2 - Pubmed citation

 

end faqaq

 

Go to top