Sarcom Ewing extrascheletal sub forma unei mase tumorale la nivelul gâtului - prezentare de caz

Sarcoma cancer on head

It has been reported a low incidence in the head and neck. Magnetic resonance imaging was useful sarcoma cancer on head preoperative evaluation. The treatment consisted in radical resection, and the histological analysis completed the diagnosis.

The postoperative management consisted in a combination of chemotherapy for systemic control and irradiation for local control. A very few cases of cervical tumors were reported.

Sarcoma cancer of the soft tissue, REVIEW-URI

Radical resection followed by radio-chemotherapy has good results in the treatment of this rare tumor. Sarcomul Ewing extrascheletal este o tumoră rară, de origine mezenchimală, similară din punct de ve­de­re histologic cu osteosarcomul Ewing. Este o tumoră rar întâlnită la nivelul capului și gâtului. Autorii pre­zin­tă un caz de sarcom Ewing extrascheletal sub forma unei tumori laterocervicale stângi situate posterior de muș­chiul sternocleidomastoidian. Examenul RMN a fost util în evaluarea preoperatorie.

Tratamentul a constat în excizia ra­di­cală a tumorii laterocervicale, urmată de examen his­to­pa­to­logic.

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Postoperator s-au efectuat chimioterapie pen­tru controlul sistemic și radioterapie pentru controlul lo­­cal. Sarcomul Ewing ex­­trascheletal este o tumoră rară, cu evoluție agresivă.

Sarcoma cancer on head

În li­te­ratură au fost raportate puține cazuri de sarcoame Ewing ex­trascheletale prezentate sub forma unor tumori la­te­ro­cervicale.

Excizia radicală urmată de radiochimioterapie are cele mai bune rezultate în tratamentul acestor tumori.

It was first recognized by Tefft et al. According to Chao et al. In head and neck, EES is usually identified in nasal or oral cavities, sinuses or soft tissues 6. EES is characterized by an aggressive course and high rate of recurrences.

Sarcom Ewing extrascheletal sub forma unei mase tumorale la nivelul gâtului - prezentare de caz

The treatment consists in a combination of surgery, radiotherapy and chemotherapy. Case report A year-old female was admitted in ENT Department with a 2-month history of painless posterior left laterocervical mass with rapid evolution Figure 1.

Sarcom Ewing extrascheletal sub forma unei mase tumorale la nivelul gâtului - prezentare de caz It has been reported a low incidence in the head and neck. Magnetic resonance imaging was useful in preoperative evaluation.

Figure 1. Figure 2.

MRI transversal plane The videofibroscopy of rhinopharynx, hypopharynx and larynx was normal. The MRI showed a posterior laterocervical solid mass, with a maximum diameter of 8 cm Figure 2 and Figure 3. Figure 3. MRI coronal plane Figure 4. Intraoperative image after complete removal of the tumor Figure 5.

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The patient at 2 months after surgery - local recurrence The patient underwent surgical excision followed by histopathological exam Figure 4. The patient sarcoma cancer on head 6 chemotherapy cycles with vincristine, doxorubicin and cyclophosphamide, followed by external radiotherapy.

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Figure 6. PET-CT scan 2 months after surgery - sagittal sarcoma cancer on head At 10 months after sarcoma cancer on head diagnosis, the patient presented with incomplete resolution of the tumor Figure 8severe radiomucositis grade 4 WHO and was admitted in the oncology department. Figure 8. EES in head and neck region must be differentiated from lymphoma, rhabdomyosarcoma, poorly differentiated salivary gland tumors, olfactory neuroblastoma, undifferentiated nasopharyngeal carcinoma and melanoma.

Case particularities The localization of EES in the neck is very rare.

Extraskeletal Ewing’s sarcoma presenting as a neck mass - case report

Comorbidities - immunosuppression caused by chronic use of prednisolone could be an etiologic factor. Delay of the radiotherapy after surgery 2 months caused tumor recurrence, EES being a very aggressive type of tumor.

Bibliografie 1. Head Neck Pathol. Hum Pathol.

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Eur J Cancer Clin Oncol. J Laryngol Otol. Windfuhr JP.

Soft Tissue Sarcoma

Primitive neuroectodermal tumor of the head and neck: incidence, diagnosis, and management. Ann Otol Rhinol Laryngol.