title: Isolated CNS vasculitis: unusual presentation of relapsed Ewing sarcoma.
abstract: 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.
authors.affiliation: Departments of Pediatric Hematology-Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
authors.forename: Polina
authors.initials: P
authors.lastname: Stepensky
authors.forename: Elisha
authors.initials: E
authors.lastname: Waldman
authors.forename: Natalia
authors.initials: N
authors.lastname: Simanovsky
authors.forename: Iris
authors.initials: I
authors.lastname: Fried
authors.forename: Shoshana
authors.initials: S
authors.lastname: Revel-Vilk
authors.forename: Igor B
authors.initials: IB
authors.lastname: Resnick
authors.forename: Michael
authors.initials: M
authors.lastname: Weintraub
mesh_terms: 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*