Ewing sarcoma - spine

Case contributed by Mahomed A. Osman
Diagnosis probable

Patient Data

Age: 4 years
x-ray
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The L5 vertebral body is markedly sclerotic. There is no periosteal reaction. Appearances in keeping with an L5 ivory vertebra.

Nuclear medicine
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A focus of increased uptake at the right lateral aspect of the L5 vertebral body.

ct
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The L5 vertebra shows diffuse homogeneous increased attenuation relative to the rest of the spine. Prevertebral soft tissue mass. The appearances are consistent with sclerosis, in this case due to Ewing sarcoma.

mri
Sagittal
T2
Sagittal
T1
Axial T1
C+ fat sat
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The L5 vertebral body is of low signal intensity with a large epidural mass occupying most of the canal. 

Case Discussion

Probable Ewing sarcoma of L5.

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