Shashaa Mohammad Nour, Hamza Amr, AlHashemi Mohamad, Alyousfi Rama, Deebo Muhammad Abu Alkheer, Katnaji Jamal
Faculty of Medicine, University of Aleppo, Aleppo, Syria.
Faculty of Medicine, University of Aleppo, Aleppo, Syria.
Int J Surg Case Rep. 2021 Aug;85:106182. doi: 10.1016/j.ijscr.2021.106182. Epub 2021 Jul 7.
Ewing's sarcoma is considered to be the second most frequent primary sarcoma in children. It affects children and young adults with a male predominance. Ewing's sarcoma is usually found in the femur, humerus, ilium and tibia; and in extremely rare cases Ewing's sarcoma might affect the scapula. There are only 15 papers in PubMed database regarding scapular Ewing's sarcoma.
A 14-year-old male, with no significant medical or surgical history, presented with a swelling in the right scapular area for two months. The patient also experienced mild pain and fever. On physical examination, there was a tender mass and restriction in the right shoulder joint movements. MRI showed a large scapular mass with the characteristics of a sarcoma. The final diagnosis was made based on pathologic findings. Eventually, the patient was subjected to neoadjuvant chemotherapy.
The most common tumors affecting scapula are chondrosarcoma and osteosarcoma. In a cohort study about patients diagnosed with ES between 1988 and 2018, only 29 cases were involved in the scapula. There are 12 cases of congenital ES have been reported in the medical literature, 3 of them were in the shoulder girdle. Surgery with neoadjuvant chemotherapy is considered better for total survival in ES of scapula in comparison with chemotherapy and/or radiotherapy alone.
Ewing sarcoma is extremely rare in the scapula and should be considered as a differential diagnosis for any patient with scapular tumor.
尤因肉瘤被认为是儿童中第二常见的原发性肉瘤。它主要影响儿童和青年，男性居多。尤因肉瘤通常发生在股骨、肱骨、髂骨和胫骨；极少数情况下，尤因肉瘤可能累及肩胛骨。在PubMed数据库中，关于肩胛骨尤因肉瘤的文献仅有15篇。
一名14岁男性，无重大内科或外科病史，右侧肩胛区肿胀两个月。患者还伴有轻度疼痛和发热。体格检查发现右肩部有压痛性肿块，肩关节活动受限。磁共振成像（MRI）显示肩胛骨有一个具有肉瘤特征的大肿块。最终诊断基于病理结果。患者最终接受了新辅助化疗。
影响肩胛骨最常见的肿瘤是软骨肉瘤和骨肉瘤。在一项关于1988年至2018年间诊断为尤因肉瘤患者的队列研究中，仅有29例累及肩胛骨。医学文献中报道了12例先天性尤因肉瘤，其中3例位于肩胛带。与单纯化疗和/或放疗相比，新辅助化疗联合手术被认为对肩胛骨尤因肉瘤的总生存期更有利。
尤因肉瘤在肩胛骨极为罕见，对于任何肩胛骨肿瘤患者都应考虑将其作为鉴别诊断。
