Yu L, Craver R, Baliga M, Ducos R, Warrier R, Ward K, Nadell J
Department of Pediatrics, Louisiana State University Medical Center, New Orleans 70112.
Med Pediatr Oncol. 1990;18(5):354-8. doi: 10.1002/mpo.2950180503.
Ewing's sarcoma, an uncommon malignant neoplasm of bone, represents about 10% of all the malignant primary bone tumors. The assumption that subclinical metastases are already present in patients with apparently localized tumor indicates the need for systemic therapy as an integral part of primary treatment. The usual sites of metastases are the lungs and skeletal system. Central nervous system (CNS) involvement is rare and is usually seen only in disseminated and fairly advanced disease. We report two patients in whom, after aggressive adjuvant chemotherapy, disease developed in the CNS without local recurrence. In one patient, meningeal involvement with malignant cells was identifiable in the cerebrospinal fluid; in the second patient, who presented with a space-occupying lesion, a diagnosis of arachnoid involvement was made histologically.
尤因肉瘤是一种罕见的骨恶性肿瘤，约占所有原发性骨恶性肿瘤的10%。对于肿瘤明显局限的患者已存在亚临床转移这一假设表明，需要将全身治疗作为初始治疗的一个组成部分。常见的转移部位是肺和骨骼系统。中枢神经系统（CNS）受累罕见，通常仅见于播散性且病情相当晚期的疾病。我们报告了两名患者，在积极的辅助化疗后，中枢神经系统出现病变，且无局部复发。其中一名患者脑脊液中可识别出有恶性细胞的脑膜受累；第二名患者表现为占位性病变，经组织学诊断为蛛网膜受累。
