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Abstract
Extraskeletal Ewing's sarcoma (EES) is a rare aggressive malignant tumor, usually occurring in the chest wall of children and young adults. Although EES shows aggressive growth pattern, it seldom demonstrates distant metastasis at diagnosis. Herein, we present computed tomography (CT) and positron emission tomography computed tomography (PET/CT) findings of EES in anterior mediastinum in a 68-year-old man, showing multi-organ distant metastasis at diagnosis. It is another atypical case with unusual presentation in point of old age, mediastinal location and distant metastasis at diagnosis, showing PET/CT findings.
Figures and Tables
Fig. 1
A 68-year-old man with extraskeletal Ewing's sarcoma in anterior mediastinum.
A. Axial CT scan shows a multilobulated, heterogeneously enhancing mass with extensive necrosis in the anterior mediastinum (arrow). Fat planes between the mass and adjacent vasculatures, aorta and main pulmonary artery, are obliaterated.
B. Axial CT scan shows a left supraclavicular lymphadenopathy with homogenous enhancement (thin arrow).
C. Axial CT scan shows a small hypodense nodular lesion (arrowhead) in the liver.
D. Axial PET/CT scan shows an anterior mediastinal mass with peripheral intense FDG uptake and central metabolic defect.
E. Maximum-intensity-projection FDG PET image shows multifocal FDG uptakes in the anterior mediastinum, both supraclavicular regions, liver, retroperitoneal nodes, spines and pelvic bones.
F. Photomicrograph (hematoxylin-eosin, original × 400) shows densely packed sheets of small round neoplastic cells. The nuclei are round with "salt and pepper" chromatin and have inconspicious or small nucleoli. Mitotic figures are common.
Note.-FDG = fluorodeoxyglucose, PET/CT = positron emission tomography/CT
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