Anterior and posterior delayed views from a bone scan.
View main image(bs) in a separate image viewer
View second image(xr). Plain AP radiograph of the pelvis.
View third image(ct). CT scan through the level of the lesion in the pelvis after IV and oral contrast administration.
Full history/Diagnosis is available below
Plain films demonstrate subtle cortical loss and bony destruction in the upper iliac crest.
Axial CT demonstrates a large soft tissue mass with lysis of the underlying bone.
Ewing's Sarcoma was first described by pathologist James Ewing in 1921. It is an uncommon, malignant bone tumor, comprising 10 to 15% of all malignant, primary bone tumors; and is also a member of the so-called "small, round, blue cell tumors" along with acute leukemia, neuroblastoma, primitive neuroectodermal tumors, Wilm's tumor, and other, more rare tumors such as small cell mesothelioma. These tumors are so named for their characteristic appearance with sheets or nests of small, tightly grouped, polygonal cells, with scant cytoplasm. Although it's appearance may be protean, the common radiographic appearance is described as permeatively lytic, with aggressive periosteal reaction, and often a soft tissue mass. Variants are commonly described including a sclerotic pattern, and soft tissue mass effect, with little cortical bony destruction. Osteomyelitis and osteosarcoma are often differential considerations.
Treatment options are variable, but include aggressive, myeloablative chemotherapy with autologous bone marrow transplantation and radiation therapy.
References and General Discussion of Bone Scintigraphy (Anatomic field:Skeletal System, Category:Neoplasm, Neoplastic-like condition)
Search for similar cases.
Edit this case
Add comments about this case
Return to the Teaching File home page.
Copyright by Wash U MO