A 16-year-old man with fever, pain & swelling in his buttock

 

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Doctor's Information

Name :  Maryam
Family :Noori
Email :   This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident :  ----------------

 

Patient's Information

Gender :  Male
Age :  16

 

Case Section

Muskuloskeletal System

 

Clinical Summary

A 16-year-old man with fever, pain & swelling in his buttock.

 

 

Imaging Procedures and Findings

The adolescent with fever, pain & swelling in his buttock, further evaluated by spiral CT scan with contrast. In the performed pelvic CT scan(axial sections), ill defined permeative bone destruction is depicted in left iliac & ischial bones associated with a large soft tissue mass with faint enhancing areas.

 

Discussion

Ewing's sarcoma belongs to the category of small round cell tumors. It is commonly seen before the age of 20, and presents with pain. One-third of patients will present with symptoms simulating infection, sclerotic reactive bone may be present at the periphery, but there is no tumor matrix. Lack of any reactive bone in the soft tissue mass distinguishes this entity from osteosarcoma. In lymphoma, hepatosplenomegaly and mixed osteolytic and osteosclerotic features are identified; EG & infection can be excluded by clinical examination, laboratory test, and possibly MRI. PNET differ histologically, but usually not radiologically. Approximately 15% to 30% of Ewing's sarcoma cases have lung and osseous metastases at presentation. Local recurrences occur in 12% to 25% of cases.

 

Final Diagnosis

Ewing Sarcoma.

 

References

Diagnostic Imaging Orthopedics, David W. Stoller. MD. FACR, Phillip F.J. Tirman. MD, Miriam A. Bredella. MD, et al. Musculoskeletal imaging; a teaching file. Felix S.Chew, Catherine C.Roberts.

 

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