title: Intra-neural Ewing's sarcoma of the upper limb mimicking a peripheral nerve tumour. A report of 2 cases.
abstract: Ewing's sarcoma is a malignant round cell tumour of bone commonly affecting children and young adults. Intra-neural Ewings is very rare form of extraosseous Ewing's sarcoma (EES), posing diagnostic and therapeutic challenges. We report two cases of intra-neural EES presenting with elbow pain and swelling, mimicking an upper limb peripheral nerve sheath tumour. Following a CT guided biopsy to confirm diagnosis, the patients were treated with a combination of surgical resection, chemotherapy and radiotherapy. These cases highlight the potential diagnostic challenges as their presentation can be misleading due to the non-specificity of symptoms. These are highly aggressive tumours with the propensity to metastasize. We review importance of collective radiological and immunohistochemical analysis followed by early, aggressive multimodal treatment within a multidisciplinary setting. This provides the best prognosis in the context of upper limb peripheral nerve tumours.
authors.affiliation: The London Sarcoma Service, The Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex HA7 4LP, UK. anitatmohan@gmail.com
authors.forename: Anita T
authors.initials: AT
authors.lastname: Mohan
authors.forename: Derek H
authors.initials: DH
authors.lastname: Park
authors.forename: Azal
authors.initials: A
authors.lastname: Jalgaonkar
authors.forename: Mohammed
authors.initials: M
authors.lastname: Alorjani
authors.forename: William
authors.initials: W
authors.lastname: Aston
authors.forename: Tim
authors.initials: T
authors.lastname: Briggs
mesh_terms: D000368:Aged; D001706:Biopsy; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000175:diagnosis*; D012512:Sarcoma, Ewing / Q000175:diagnosis* / Q000601:surgery; D014457:Ulna; D014459:Ulnar Nerve; D055815:Young Adult