Ewing sarcoma of the chest wall

Case contributed by Aliakbar Sahraei
Diagnosis certain


5 year old male who came with chest pain, fever, shortness of breath and cough for 2 months prior to admission.

Patient Data

Age: 5 y/o
Gender: Male

This PA Chest x ray demonstrate opacification of the left hemithorax, with marked positive mass effect and shift of the heart and mediastinum towards the right. Destruction of the anterior part of left 7th rib.

Axial CECT image shows a pleural-based contrast enhanced heterogeneous mass with multiple areas of cystic degeneration, adjacent 7th left rib bone destruction and a large pleural effusion, which displaces the heart and mediastinum to the right.

Case Discussion

Chest x-ray and CT of a 5 year old male with a large destructive soft tissue mass arising from the left chest wall and destruction of much of the 7th rib. On contrast CT, the mass heterogeneously enhances.

Features are consistent with the subsequently tissue proven Ewing sarcoma of the chest wall.

Not surprisingly the demographics of these chest wall tumors are similar to those of Ewing sarcomas elsewhere, seen predominantly in children and young adults 1. Ewing sarcomas account for 10-15% of all primary chest wall tumors 2.

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