Ewing sarcoma - middle finger

Case contributed by Hani M. Al Salam
Diagnosis certain

Presentation

History of swelling of the third digit of the right hand for 6 years.

Patient Data

Age: 30 years
Gender: Male

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Right hand

x-ray
Frontal
Oblique
Lateral
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Info

A destructive soft tissue mass lesion is noted epicentered on the middle phalanx of the right hand, which shows near total destruction. Its remnants show expansion and marked osteolytic changes. This is also involving the distal half of the proximal phalanx, showing mild expansion, osteolysis with prominent trabeculae.

Right hand

mri
Coronal T2
fat sat
Axial T2
fat sat
Sagittal
T2 fat sat
Axial T1
fat sat
Axial T1
fat sat
Axial T1
C+ fat sat
Sagittal T1
C+ fat sat
Coronal T1
C+ fat sat
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Info

Soft tissue mass lesion is noted replacing the middle phalanx of the middle finger of the right hand with intense postcontrast enhancement. It is also involving the medullary cavity of the proximal phalanx.

Nuclear medicine
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Info

Increased uptake of the middle finger osteolytic destructive soft tissue mass lesion.

Case Discussion

Pathologically proved Ewing sarcoma.

Ewing's sarcoma of the finger is very rare and, pain & swelling of the affected finger are the most frequent presenting features.

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