Ewing sarcoma of the rib

Case contributed by Naim Qaqish
Diagnosis certain


Growing left chest wall mass.

Patient Data

Age: 20 years
Gender: Male


An oval-shaped ill-defined heterogeneous enhancing soft tissue mass lesion with areas of cystic degeneration and containing calcification is seen arising from the 11th rib antero- medially . It measures around eight by seven by three centimeters in dimensions. This lesion is consistent with Ewing’s sarcoma.

Periosteal reaction to the adjacent rib is also seen.

Both lung fields appear clear without evidence of metastasis.

Hila and mediastinum appear normal without evidence of lymphadenopathy or mass lesions.

The liver and spleen appear normal in size and homogenous without evidence of focal lesion.

Kidneys, adrenal glands, and pancreas appear normal without evidence of focal lesions.

No evidence of significant retroperitoneal, abdominal or pelvic lymphadenopathy or fluid collection.

Case Discussion

This is 20 year old presenting to his physician with growing chest wall mass. Further evaluation by chest CT with contrast was requested showing lesion arising from the left eleventh rib with heterogeneous attenuation, areas of cystic degeneration, and enhancement of its solid components on post-contrast images.  Biopsy of this left chest wall mass was performed and confirmed Ewing's sarcoma of the chest wall.

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