Concurrent Ewing sarcoma family of tumors and fibrous dysplasia: possible diagnostic pitfall.
We present 2 patients with synchronous Ewing sarcoma family of tumors (ESFTs) and fibro-osseous lesion in the independent sites, possibly causing misjudgment in staging. Each patient showed another activity apart from the primary ESFT lesion on gallium and/or thallium scintigraphy at initial presentation. Of note is that such lesions showed no obvious radiologic change even though the primary ESFT lesions were mildly shrunken during chemotherapy. The biopsies confirmed fibrous dysplasia (FD) in the first patient and fibro-osseous lesion, possibly FD in the second patient. As far as we know, concurrent ESFT and FD in independent sites have never been described. However, this unusual combination emphasized the possibility of concurrent FD mimicking metastasis in a patient with malignancy and the view that exploratory biopsy should be performed in a critical case to make staging. Further investigation will be required about whether the co-occurrence of ESFD and FD in our patients is coincidence or genetic linkage.
Kato
Keisuke
K
Division of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan. kato5577@d2.dion.ne.jp
Hayashi
Tsuyuko
T
Tabuchi
Ken
K
Okuzumi
Nariharu
N
Kigasawa
Hisato
H
Abe
Yasuko
Y
Toyoda
Yasunori
Y
Aida
Noriko
N
Sekido
Ken-ichi
K
Sato
Hironobu
H
Tanaka
Mio
M
Tanaka
Yukichi
Y
D000293:Adolescent; D001706:Biopsy; D001859:Bone Neoplasms / Q000473:pathology*; D002648:Child; D003937:Diagnosis, Differential; D005189:False Positive Reactions; D005260:Female; D018214:Fibroma, Ossifying / Q000473:pathology*; D005357:Fibrous Dysplasia of Bone / Q000473:pathology*; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D012512:Sarcoma, Ewing / Q000473:pathology*