Guevara Carlos, Acosta Julbe José I, Rodríguez-Reyes Derick, Bibiloni Juan
Department of Orthopedic Surgery, University of Puerto Rico Medical Sciences Campus, Puerto Rico.
Department of Orthopedic Surgery, University of Puerto Rico Medical Sciences Campus, Puerto Rico.
Int J Surg Case Rep. 2024 Dec;125:110552. doi: 10.1016/j.ijscr.2024.110552. Epub 2024 Nov 6.
Ewing sarcoma (EwS) is an uncommon and highly aggressive cancer primarily affecting children and young adults. This tumor constitutes 10 % to 15 % of all bone sarcomas and often presents in the pelvis, axial skeleton, and femur. Despite its rarity, EwS's rapid progression and early metastatic potential make it a significant concern in pediatric oncology, highlighting the need for effective treatment protocols and further research.
We report the case of an 18-year-old Hispanic male who presented with an initially asymptomatic growing mass in his right distal left thumb. The diagnosis of an extra-axial EwS was confirmed after histopathologic evaluation. He was managed with a trans-interphalangeal disarticulation followed by adjuvant chemotherapy with no signs of recurrence at 24-months. This case has been reported in line with the SURGICAL CASE Reports (SCARE) guidelines.
EwS is known for rapid growth and early metastasis, often remaining asymptomatic until advanced stages, complicating treatment and reducing survival. Common symptoms include tenderness and swelling. In our case, the patient presented with a slowly enlarging, initially asymptomatic thumb mass, leading to delayed diagnosis. EwS in the hand, especially the thumb, is rare, with only nine cases reported.
While EwS rarely manifests in fingers, it remains crucial to include this diagnosis and other malignant tumors as a potential consideration when evaluating lesions found in this area.
尤因肉瘤(EwS)是一种罕见且侵袭性很强的癌症,主要影响儿童和年轻人。这种肿瘤占所有骨肉瘤的10%至15%,常出现在骨盆、中轴骨骼和股骨。尽管尤因肉瘤罕见,但其快速进展和早期转移潜能使其成为儿科肿瘤学中的一个重大问题,凸显了有效治疗方案和进一步研究的必要性。
我们报告一例18岁西班牙裔男性病例,其右拇指远节指骨近端最初出现一个无症状的进行性肿块。经组织病理学评估后确诊为轴外尤因肉瘤。他接受了经指间关节离断术,随后进行辅助化疗,24个月时无复发迹象。本病例已按照《外科病例报告》(SCARE)指南进行报告。
尤因肉瘤以生长迅速和早期转移著称,通常在晚期之前无症状,这使治疗复杂化并降低生存率。常见症状包括压痛和肿胀。在我们的病例中,患者表现为一个缓慢增大、最初无症状的拇指肿块,导致诊断延迟。手部尤因肉瘤,尤其是拇指部位的,很罕见,仅有9例报告。
虽然尤因肉瘤很少在手指出现,但在评估该区域发现的病变时,将这一诊断及其他恶性肿瘤作为潜在考虑因素仍然至关重要。