Clinical management of Ewing sarcoma of the bones of the hands and feet: a retrospective single-institution review.
OBJECTIVE
Bones of the hands and feet are uncommon sites for Ewing sarcoma. In this study, we reviewed our experience in the management of these tumors.


METHODS
We retrospectively reviewed clinical presentation, management, and outcome of patients with Ewing sarcoma of the bones of hands and feet treated at our institution (1981-2006).


RESULTS
The cohort included 6 males and 3 females (8 white, 1 African American; median age at diagnosis, 15 years). Primary tumor site was the hand in 6 and the foot in 3 patients. Three patients had distant metastatic disease at diagnosis (lung [n = 2]; ipsilateral axillary lymph node[(n = 1]). All patients had painful swelling at the primary site, and 2 (22%) had pathological fracture. All patients received chemotherapy and local control measures (surgery [n = 6], radiation [n = 2], surgery and radiation [(n = 1]). Three patients received radiotherapy for distant metastases. Three patients had systemic recurrence (lungs [n = 2], lung and brain [n = 1]); none had local tumor recurrence. Median follow-up was 5 years. Five patients (55.6%) are alive at last follow-up.


CONCLUSIONS
Chemotherapy and surgical excision of primary tumor are the mainstays of treatment. Radiotherapy is recommended for local control of lesions in the hand for patients declining excisional therapy.
Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN 38105-3678, USA.
Lalit
L
Parida
Israel
I
Fernandez-Pineda
John
J
Uffman
Fariba
F
Navid
Andrew M
AM
Davidoff
Michael
M
Neel
Matthew J
MJ
Krasin
Bhaskar N
BN
Rao
D000293:Adolescent; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D002648:Child; D005260:Female; D005529:Foot Bones; D050276:Hand Bones; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000175:diagnosis* / Q000628:therapy*