title: Intracardiac Low-grade Sarcoma Following Treatment for Ewing Sarcoma.
abstract: A 16-year-old male was diagnosed with Ewing sarcoma of the ribcage with pulmonary metastases. Six months after completion of scheduled therapy, he was found to have a new intracardiac mass, presumed recurrent Ewing sarcoma. EWSR1 fusion was not detected by droplet digital polymerase chain reaction from blood plasma. After no improvement with salvage chemotherapy, he underwent surgical resection that identified a low-grade spindle cell sarcoma. Despite the near-synchronous presentation of 2 unrelated sarcomas, extensive genomic analyses did not reveal any unifying somatic or germline mutations nor any apparent cancer predisposition. This case also highlights the potential role of utilizing plasma cell-free DNA for diagnosing tumors in locations where biopsy confers high morbidity.
authors.affiliation: Departments of *Pediatrics †Medicine ‡Surgery ∥Radiation Oncology ¶Radiology #Pathology **Human Oncology and Pathogenesis Program, Molecular Pharmacology Program ††Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center §Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, NY.
authors.forename: Michael V
authors.initials: MV
authors.lastname: Ortiz
authors.forename: Heather
authors.initials: H
authors.lastname: Magnan
authors.forename: Emily K
authors.initials: EK
authors.lastname: Slotkin
authors.forename: Srikanth R
authors.initials: SR
authors.lastname: Ambati
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Chou
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Wexler
authors.forename: Paul A
authors.initials: PA
authors.lastname: Meyers
authors.forename: Michael F
authors.initials: MF
authors.lastname: Walsh
authors.forename: Todd
authors.initials: T
authors.lastname: Heaton
authors.forename: Leonard N
authors.initials: LN
authors.lastname: Girardi
authors.forename: Suzanne L
authors.initials: SL
authors.lastname: Wolden
authors.forename: Anita P
authors.initials: AP
authors.lastname: Price
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Kennedy
authors.forename: Ahmet
authors.initials: A
authors.lastname: Zehir
authors.forename: Meera
authors.initials: M
authors.lastname: Hameed
authors.forename: Michael F
authors.initials: MF
authors.lastname: Berger
authors.forename: Alex
authors.initials: A
authors.lastname: Kentsis
authors.forename: Neerav
authors.initials: N
authors.lastname: Shukla
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001706:Biopsy; D002148:Calmodulin-Binding Proteins / Q000235:genetics; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D008297:Male; D009154:Mutation; D016609:Neoplasms, Second Primary; D034802:RNA-Binding Protein EWS; D016601:RNA-Binding Proteins / Q000235:genetics; D012509:Sarcoma / Q000175:diagnosis* / Q000209:etiology*; D012512:Sarcoma, Ewing / Q000150:complications* / Q000175:diagnosis / Q000235:genetics / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D002148:Calmodulin-Binding Proteins; C500986:EWSR1 protein, human; D034802:RNA-Binding Protein EWS; D016601:RNA-Binding Proteins