Ewing sarcoma

Case contributed by Hani M. Al Salam
Diagnosis certain

Presentation

Left shoulder swelling.

Patient Data

Age: 6 years
Gender: Female
x-ray
Lateral
Frontal
Frontal
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Info

Large expansile mass involving the proximal humeral metaphysis. 

Nuclear medicine
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Info

Increased activity in the left proximal humerus. 

mri
This study is a stack
Axial
T1
This study is a stack
Coronal T2
fat sat
This study is a stack
Axial T1
fat sat
This study is a stack
Axial T2
fat sat
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Sagittal
T1 C+
This study is a stack
Coronal T1
C+ fat sat
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MRI not only confirms the presence of a mass but also demonstrates a large extra-osseous component both laterally beneath deltoid, as well as medially into the axilla. The mass is isointense to muscle on T1, heterogeneously high on T2 and demonstrates extensive contrast enhancement.

Case Discussion

Pathologically proven Ewing sarcoma

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