Ewing sarcoma - spine

Case contributed by Dr Mahomed A. Osman

Patient Data

Age: 4 years
X-ray

The L5 vertebral body is markedly sclerotic. There is no periosteal reaction. Appearances in keeping with an L5 ivory vertebra.

Nuclear medicine

A focus of increased uptake at the right lateral aspect of the L5 vertebral body.

CT

The L5 vertebra shows diffuse homogeneous increased attenuation relative to the rest of the spine. Prevertebral soft tissue mass. The appearances are consistent with sclerosis, in this case due to Ewing sarcoma.

MRI

The L5 vertebral body is of low signal intensity with a large epidural mass occupying most of the canal. 

Case Discussion

Probable Ewing sarcoma of L5.

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