Ewing sarcoma (1st metacarpal)

Case contributed by Dr Jeremy Jones

Presentation

Thumb swelling and pain but no recent trauma.

Patient Data

Age: 10
Gender: Male
Modality: X-ray

The thumb metacarpal is expanded with coarse trabeculation and periosteal new bone formation. There is cortical breech medially and the impression of a soft tissue mass associated with the aggressive bone lesion.

Modality: MRI

The abnormal thumb metacarpal is demonstrated here replaced with tumour and associated with a large extra-osseous soft tissue mass and peritumoural oedema.

Case Discussion

The thumb metacarpal is abnormal. There is a tumour centred on the metacarpal which has extended from the bone and into the surrounding soft-tissues as an extraosseous soft tissue mass. There is associated oedema in the bone and extending into the muscles surrounding the tumour.

This tumour is centred on the bone and in paediatric patients, the short differential for bone tumours runs to:

The age of the patient, location, and soft tissue mass point towards Ewing sarcoma.

Ewing sarcoma was confirmed histologically.

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Case Information

rID: 26694
Case created: 3rd Jan 2014
Last edited: 9th May 2017
Inclusion in quiz mode: Included

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