Isolated CNS vasculitis: unusual presentation of relapsed Ewing sarcoma.
We describe a 12-year-old boy male who presented with an expressive dysphasia after completion of treatment for unifocal Ewing sarcoma. CNS vasculitis was diagnosed by MRI/MRA and cerebral angiography. Extensive rheumatologic work-up failed to identify an underlying primary process. Restaging studies showed no evidence of tumor. Complete neurologic recovery was achieved on prednisone. Four months later the patient developed overt, extensive metastases, confirmed by biopsy to represent recurrent Ewing sarcoma. Despite intensive therapy the patient succumbed 6 months later. This case demonstrates the unique finding of isolated CNS vasculitis as a presenting sign of Ewing sarcoma.
Stepensky
Polina
P
Departments of Pediatric Hematology-Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
Waldman
Elisha
E
Simanovsky
Natalia
N
Fried
Iris
I
Revel-Vilk
Shoshana
S
Resnick
Igor B
IB
Weintraub
Michael
M
D001037:Aphasia / Q000209:etiology; D002533:Cerebral Angiography; D002648:Child; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020361:Paraneoplastic Syndromes, Nervous System / Q000209:etiology*; D012008:Recurrence; D012512:Sarcoma, Ewing / Q000150:complications* / Q000473:pathology; D020293:Vasculitis, Central Nervous System / Q000209:etiology*