Presentation
20-year-old female patient with left lower limb and left iliac fossa pain of 1-year duration with x-ray showing left iliac bony lesion (not included).
Patient Data
Left iliac bone para-sacroiliac joint expansion with marrow infiltration, surrounding cortical disruption, aggressive periosteal reaction (spiculated) and sizable circumferential soft tissue mass showing intra and extrapelvic components. The extrapelvic soft tissue component is more sizable posteriorly and laterally infiltrating the left gluteus medius muscle and stretching the gluteus maximus muscle. The intrapelvic soft tissue component is seen infiltrating the iliacus and psoas muscles. The mass is eliciting homogenous intermediate signal on T1 WIs and low to intermediate signal on T2 WIs with heterogenous vivid post contrast enhancement.
Obliterated left sacroiliac joint by the neoplastic process with adjacent sacral marrow infiltration.
Case Discussion
Left iliac bone destructive osseous lesion with soft tissue components in a young patient makes Ewing sarcoma most likely. Biopsy was done revealing Ewing sarcoma.
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