Abstract
Ewing’s sarcoma is a relatively rare malignancy, occurring mainly between 4 and 25 years of age. It usually arises from the pelvis, followed by the femur, tibia, and remainder of both the long bones of the extremities and flat bones of the axial skeleton. To the best of our knowledge, Ewing’s sarcoma of the patella has never been reported previously. Patellar tumors occur infrequently and represent an uncommon etiology of anterior knee pain. We describe the rare case of a 41-year-old man who presented with a 3–4 month history of escalating right anterior knee pain and swelling. Imaging demonstrated an aggressive patellar tumor with an adjacent soft tissue mass. The diagnosis of Ewing’s sarcoma was confirmed by pathology. Physicians should be aware of atypical locations for Ewing’s sarcoma and, conversely, of rare tumors arising in the patella and accounting for anterior knee pain. Early recognition of such malignancies allows prompt initiation of treatment, hence improving prognosis.
References
Karosas AO. Ewing’s sarcoma. Am J Health Syst Pharm. 2010;67(19):1599–605.
Potratz J, Dirksen U, Jürgens H, Craft A. Ewing sarcoma: clinical state-of-the-art. Pediatr Hematol Oncol. 2012;29(1):1–11.
Jürgens H, Dirksen U. Ewing sarcoma treatment. Eur J Cancer. 2011;47 Suppl 3:S366–7.
Kransdorf MJ, Moser RP, Vinh TN, Aoki J, Callaghan JJ. Primary tumors of the patella. A review of 42 cases. Skeletal Radiol. 1989;18(5):365–71.
Mercuri M, Casadei R. Patellar tumors. Clin Orthop Relat Res. 2001;389:35–46.
Chida S, Nagasawa H, Okada K, Shimada Y. Osteosarcoma of the patella: a case report. Ups J Med Sci. 2012;117(3):342–6.
Ferguson PC, Griffin AM, Bell RS. Primary patellar tumors. Clin Orthop Relat Res. 1997;336:199–204.
Bhagat S, Sharma H, Bansal M, Reid R. Presentation and outcome of primary tumors of the patella. J Knee Surg. 2008;21(3):212–6.
Saglik Y, Yildiz Y, Basarir K, Tezen E, Güner D. Tumours and tumour-like lesions of the patella: a report of eight cases. Acta Orthop Belg. 2008;74(3):391–6.
Pluot E, Davies AM, James SLJ, Sundaram M. Tumours and Tumour-Like Lesions of the Patella Imaging of Bone Tumors and Tumor-Like Lesions. Heidelberg: Springer Berlin; 2009. p. 637–46.
Singh J, James SL, Kroon HM, Woertler K, Anderson SE, Jundt G, et al. Tumour and tumour-like lesions of the patella–a multicentre experience. Eur Radiol. 2009;19(3):701–12.
Hedayati B, Saifuddin A. Focal lesions of the patella. Skeletal Radiol. 2009;38(8):741–9.
Iwamoto Y. Diagnosis and treatment of Ewing’s sarcoma. Jpn J Clin Oncol. 2007;37(2):79–89.
Balamuth NJ, Womer RB. Ewing’s sarcoma. Lancet Oncol. 2010;11(2):184–92.
Reinus WR, Gilula LA, Committee I. Radiology of Ewing’s sarcoma: intergroup Ewing’s Sarcoma Study (IESS). RadioGraphics. 1984;4(6):929–44.
Bacci G, Balladelli A, Forni C, Ferrari S, Longhi A, Bacchini P, et al. Adjuvant and neoadjuvant chemotherapy for Ewing sarcoma family tumors in patients aged between 40 and 60: report of 35 cases and comparison of results with 586 younger patients treated with the same protocols in the same years. Cancer. 2007;109(4):780–6.
Bridge RS, Rajaram V, Dehner LP, Pfeifer JD, Perry A. Molecular diagnosis of Ewing sarcoma/primitive neuroectodermal tumor in routinely processed tissue: a comparison of two FISH strategies and RT-PCR in malignant round cell tumors. Mod Pathol. 2006;19(1):1–8.
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Gorelik, N., Dickson, B.C., Wunder, J.S. et al. Ewing’s sarcoma of the patella. Skeletal Radiol 42, 729–733 (2013). https://doi.org/10.1007/s00256-013-1580-0
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DOI: https://doi.org/10.1007/s00256-013-1580-0