Al-Quds University, Jerusalem, Palestine.
An-Najah National University, Nablus, Palestine.
J Investig Med High Impact Case Rep. 2024 Jan-Dec;12:23247096241286358. doi: 10.1177/23247096241286358.
Ewing's sarcoma, a rare primary bone malignancy primarily affecting adolescents and young adults, typically manifests in the pelvic bones and femur. Primary Ewing's sarcoma of the sternum is exceptionally rare, constituting less than 1% of cases. We present a case of a 34-year-old man with a 2-month history of anterior chest wall pain initially attributed to muscular spasm. Subsequently, the patient developed a palpable mass and imaging demonstrated a mid-lower sternal lesion with cortical destruction and soft tissue involvement, confirmed as Ewing's sarcoma on biopsy. In addition, a suspicious lesion was identified in the left distal tibia, which was histologically confirmed as a metastasis from the primary sternal sarcoma. Neoadjuvant chemotherapy preceded partial sternotomy with rib resection and reconstruction, achieving clear surgical margins. Postoperative evaluation showed shrinkage in the sternal lesion and near-resolution of the tibial metastasis. Subsequent chemotherapy cycles resulted in no evidence of the disease on the follow-up positron emission tomography scan. This case underscores the diagnostic challenges of primary sternal Ewing's sarcoma and emphasizes the importance of early recognition and comprehensive evaluation in managing such rare presentations.
尤因氏肉瘤是一种罕见的原发性骨恶性肿瘤，主要影响青少年和年轻成年人，通常表现为骨盆骨和股骨。胸骨原发性尤因氏肉瘤极为罕见，不到病例的 1%。我们报告了 1 例 34 岁男性患者，其胸骨前壁疼痛病史 2 个月，最初归因于肌肉痉挛。随后，患者出现可触及的肿块，影像学显示胸骨中下段病变伴皮质破坏和软组织受累，经活检证实为尤因氏肉瘤。此外，左胫骨远端还发现了一个可疑病灶，经组织学证实为原发性胸骨肉瘤的转移。新辅助化疗后行部分胸骨切开术，切除肋骨并重建，获得了清晰的手术切缘。术后评估显示胸骨病变缩小，胫骨转移灶几乎消退。随后的化疗周期显示随访正电子发射断层扫描无疾病证据。该病例强调了原发性胸骨尤因氏肉瘤的诊断挑战，并强调了早期识别和全面评估在处理此类罕见表现中的重要性。
