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Ewing's sarcoma

A retrospective study of histological and immunohistochemical factors and their relation to prognosis

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Summary

Histological and immunohistochemical features of 87 patients with conventionally diagnosed Ewing's sarcoma were studied retrospectively on routinely processed material and evaluated with regard to prognostic significance. 74% were convincingly positive when stained for vimentin, 13% were doubtful, and 13% were negative. A varying degree of positivity for neuron-specific enolase (NSE) was found in 15%; these cases all co-expressed vimentin. A single tumour contained scattered cytokeratin-positive cells. Positivity for the leukocyte common antigen (LCA) could be demonstrated in three cases; these were excluded from the statistical analysis of prognostic factors.

Growth pattern, soft tissue invasion, monomorphic or dimorphic cell population, and PAS-, NSE- or vimentin-positivity did not influence survival significantly. However, prognosis was increasingly poor with increasing degree of necrosis: median survival was 28 months for grade I necrosis (<10%), 16 months for grade II (10–50%), and 11 months for grade III (>50%),p<0.0005. A mitosis count of <1 per high-powerfield (HPF) was correlated to a median survival of 26 months, ≥ 1 per HPF to 12 months,p<0.05.

The findings indicate some degree of heterogeneity in Ewing's sarcoma which may be related to primitive peripheral neuroectodermal tumours (PNETs), or be a true blastoma. In future trials, diagnostic criteria (including immunohistochemistry) should be clearly defined and materials should be large enough to allow for stratification according to prognostic factors.

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Authors and Affiliations

  1. The Bone and Soft Tissue Tumour Centres of Copenhagen and of Aarhus: Department of Pathology, The Finsen Institute/Rigshospitalet, Copenhagen

    S. Daugaard & T. Schiødt

  2. Department of Oncology ONA and Orthopaedics, The Finsen Institute/Rigshospitalet, Copenhagen

    C. Kamby

  3. Hospital of Orthopaedics and Department of Oncology, The Municipal Hospital, Aarhus

    L. M. Sunde

  4. Department of Pathology, The County Hospital, Aarhus, Denmark

    O. Myhre-Jensen

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  1. S. Daugaard
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  2. C. Kamby
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  3. L. M. Sunde
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  4. O. Myhre-Jensen
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  5. T. Schiødt
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Daugaard, S., Kamby, C., Sunde, L.M. et al. Ewing's sarcoma. Vichows Archiv A Pathol Anat 414, 243–251 (1989). https://doi.org/10.1007/BF00822028

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