GOOD NEWS: We have fixed the DICOM uploading problem. New cases should work fine. More info radiopaedia.org/chat

Ewing sarcoma - femur

Case contributed by Samir Benoudina
Diagnosis certain

Presentation

Atraumatic pain, swelling of left thigh since 2 months. Reduced range of motion of the knee.

Patient Data

Age: 16 years
Gender: Male
x-ray

There is a lesion located in the distal femur with typical aggressive features of a malignant tumor with:

  • irregular and partial destruction of cortical bone
  • periosteal reaction with Codman triangle formation
  • indistinct zone of transition
  • perpendicular spiculations producing a sunburst appearance
  • associated large soft tissue swelling

Histologically proven Ewing sarcoma.

Annotated image
  • Green: Cortical bone destruction
  • Pink: Periosteal reaction
  • Arrow: Codman triangle
  • Blue: Sunburst appearance
  • Yellow lines: Cortical thinning
  • Gray lines: soft tissue expansion

Case Discussion

Pathologically proven Ewing sarcoma. This is a highly malignant bone tumor seen in the first two decades of life. The main differential diagnosis is osteosarcoma.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.