title: A case of small bowel metastasis from spinal Ewing sarcoma causing intussusception in an adult female.
abstract: BACKGROUND
  Ewing sarcomas are highly aggressive malignant tumours occurring predominantly in the long bones of the extremities in children and young adults. About 20 % of patients will present with metastases at diagnosis with the commonest sites being the lungs, bone and bone marrow. Cases of primary small bowel Ewing sarcomas have been described but are nonetheless exceedingly rare, even more so cases of metastasis to the small bowel.
  
  
  METHODS
  We describe a case of vertebral Ewing sarcoma in a 44 year-old female which metastasized to the jejunum causing intussusception.
  
  
  CONCLUSIONS
  Ewing's sarcoma is highly aggressive and presence of metastases, overt or subclinical, is thought to be present in almost all patients at diagnosis. As evidenced by our patient, metastatic disease can progress rapidly to cause further complications and confer a poorer survival. The possibility of metastasis, no matter how rare or unlikely the site is, should be considered and actively investigated to expedite treatment of the primary disease.
authors.affiliation: Department of General Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. tan.qing.ting@kkh.com.sg.
authors.forename: Qing Ting
authors.initials: QT
authors.lastname: Tan
authors.affiliation: Department of Hepatopancreaticobiliary Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
authors.forename: Jin Yao
authors.initials: JY
authors.lastname: Teo
authors.affiliation: Department of Pathology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
authors.forename: Syed Salahuddin
authors.initials: SS
authors.lastname: Ahmed
authors.affiliation: Department of Hepatopancreaticobiliary Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
authors.forename: Alexander Yaw Fui
authors.initials: AY
authors.lastname: Chung
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000473:pathology* / Q000601:surgery; D007443:Intussusception / Q000473:pathology* / Q000601:surgery; D007580:Jejunal Neoplasms / Q000556:secondary* / Q000601:surgery; D012512:Sarcoma, Ewing / Q000473:pathology* / Q000601:surgery; D013125:Spinal Neoplasms / Q000473:pathology* / Q000601:surgery
keywords: Adult; Ewing sarcoma; Intestinal; Intussusception; Metastasis; Obstruction; Small bowel