Iliac bone Ewing sarcoma
20-year-old female patient with left lower limb and left iliac fossa pain of 1-year duration with x-ray showing left iliac bony lesion (not included).
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Left iliac bone para-sacroiliac joint expansion with marrow infiltration, surrounding cortical disruption, aggressive periosteal reaction (spiculated) and sizable circumferential soft tissue mass showing intra and extrapelvic components. The extrapelvic soft tissue component is more sizable posteriorly and laterally infiltrating the left gluteus medius muscle and stretching the gluteus maximus muscle. The intrapelvic soft tissue component is seen infiltrating the iliacus and psoas muscles. The mass is eliciting homogenous intermediate signal on T1 WIs and low to intermediate signal on T2 WIs with heterogenous vivid post contrast enhancement.
Obliterated left sacroiliac joint by the neoplastic process with adjacent sacral marrow infiltration.
Left iliac bone destructive osseous lesion with soft tissue components in a young patient makes Ewing sarcoma most likely. Biopsy was done revealing Ewing sarcoma.
- Murphey MD, Senchak LT, Mambalam PK, Logie CI, Klassen-Fischer MK, Kransdorf MJ. From the radiologic pathology archives: ewing sarcoma family of tumors: radiologic-pathologic correlation. (2013) Radiographics : a review publication of the Radiological Society of North America, Inc. 33 (3): 803-31. doi:10.1148/rg.333135005 - Pubmed