title: Extraskeletal Ewing's sarcoma: a case report and review of the literature.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  To report on the diagnosis and current treatment of a rare tumor about the cervical spine.
  
  
  BACKGROUND
  Extraskeletal Ewing's sarcoma (EES) is rare and has not been previously described about the cervical spine. We present a case of a 24-year-old man with a large mass in the posterior triangle of the neck extending through the vertebral foramens of the cervical vertebrae. This was identified as an extraskeletal Ewing's sarcoma. Traditional treatment paradigms have been associated with a poor prognosis. Since the recommendations of the Intergroup Rhabdomyosarcoma Study II study of multimodal chemotherapy and radiotherapy, this tumor has a significantly better prognosis.
  
  
  METHODS
  Surgical debulking of the tumor was necessary to relieve cord compression. Histologic analysis was used to confirm both magnetic resonance imaging and computed tomography diagnosis. A chemoradiation therapy program was commenced in accordance with Intergroup Rhabdomyosarcoma Study II recommendations.
  
  
  RESULTS
  Computed tomography and magnetic resonance imaging demonstrated a large lobulated mass extending through the exit foramens of C2/C3 and C3/C4. The mass was entirely extraskeletal and extradural. Histologic examination of the excised mass showed microscopy consistent with extraskeletal Ewing's sarcoma. After surgical debulking and chemoradiation, the patient made a complete recovery.
  
  
  CONCLUSIONS
  A review of the literature confirms that extraskeletal Ewing's sarcoma is a rare tumor and particularly so in the region of the cervical spine. Early diagnosis and surgical debulking combined with current multimodality chemoradiation programs can produce a favorable outcome.
authors.affiliation: Departments of Orthopaedic Surgery, St. Vincent's Hospital, Elm Park, Dublin, Ireland.
authors.forename: J G
authors.initials: JG
authors.lastname: Kennedy
authors.forename: S
authors.initials: S
authors.lastname: Eustace
authors.forename: R
authors.initials: R
authors.lastname: Caulfield
authors.forename: D J
authors.initials: DJ
authors.lastname: Fennelly
authors.forename: B
authors.initials: B
authors.lastname: Hurson
authors.forename: K S
authors.initials: KS
authors.lastname: O'Rourke
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000473:pathology*; D003131:Combined Modality Therapy; D003609:Dactinomycin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage; D007796:Laminectomy; D008297:Male; D011878:Radiotherapy; D012512:Sarcoma, Ewing / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage
chemical_list: D003609:Dactinomycin; D014750:Vincristine; D004317:Doxorubicin; D007069:Ifosfamide