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Ewing’s sarcoma of proximal phalanx of the hand with skip metastases to metacarpals

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Abstract

Ewing’s sarcoma is the second most common malignant primary bone tumor of childhood and adolescence affecting mainly the diaphysis of long bones and flat bones. This tumor is extraordinarily rare in small bones of the hand and presents as a swelling with atypical radiological features of cystic and lytic lesion with scant periosteal reaction. The common differential diagnosis include osteomyelitis, tuberculosis, enchondroma and benign tumors. Moreover, skip metastasis to adjacent bones is even rarer. The prognosis of this condition is greatly influenced by the presence of metastasis at presentation, further emphasizing the importance of early diagnosis. Multimodality treatment using surgery, radiotherapy and chemotherapy is currently recommended though no consensus exists. We report a case of Ewing’s sarcoma of the little finger proximal phalanx which was initially missed and developed skip metastasis to several metacarpals within 4 months.

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References

  1. Siddiqui YS, Zahid M, Sabir AB, Asif N, Kumar G, Akhtar M. Calcaneal Ewing’s sarcoma with skip metastases to the adjacent tarsal bones. J Clin Diagn Res 2011;5:117–9.

    Google Scholar 

  2. Mohan V, Gupta RP. Ewing’s sarcoma of the small bones of hands and feet. J Radiol Imaging 2002;12:403–5.

    Google Scholar 

  3. Escobedo EM, Bjokengren AG, Moore SG. Ewing’s sarcoma of the hand. Am J Radiol 1993;159:101–2.

    Google Scholar 

  4. Bernstein M, Kovar H, Paulussen M, Randall RL, Schuck A, Teot LA, et al. Ewing’s sarcoma family of tumors: Current management. Oncologist 2006;11:503–19.

    Article  CAS  Google Scholar 

  5. Jose Jerome JT, Varghese M, Thirumagal SB. Ewing’s sarcoma of the distal phalanx of little finger. Internet J Oncol 2007;4

    Google Scholar 

  6. Sforzo CR, Scarborough MT, Wright TW. Bone-forming tumors of the upper extremity and Ewing’s sarcoma. Hand Clin 2004;20:303–15, vi.

    Article  Google Scholar 

  7. Thomas BP, Sasi K, Pallapati SC, Mathew A, Sreekanth R, Thomas M. Malignant tumours of the hand and wrist. Indian J Plast Surg 2011;44:337–47.

    Article  Google Scholar 

  8. Sharma P, Khangembam BC, Suman KC, Singh H, Rastogi S, Khan SA, et al. Diagnostic accuracy of 18F-FDG PET/CT for detecting recurrence in patients with primary skeletal Ewing sarcoma. Eur J Nucl Med Mol Imaging 2013;40:1036–43.

    Article  CAS  Google Scholar 

  9. McCarville MB, Christie R, Daw NC, Spunt SL, Kaste SC. PET/CT in the evaluation of childhood sarcomas. AJR Am J Roentgenol 2005;184:1293–304.

    Article  Google Scholar 

  10. Reinus WR, Gilula LA, Shirley SK, Askin FB, Siegal GP. Radiographic appearance of Ewing sarcoma of the hands and feet: Report from the intergroup Ewing sarcoma study. AJR Am J Roentgenol 1985;144:331–6.

    Article  CAS  Google Scholar 

  11. Wunder JS, Paulian G, Huvos AG, Heller G, Meyers PA, Healey JH. The histological response to chemotherapy as a predictor of the oncological outcome of operative treatment of Ewing sarcoma. J Bone Joint Surg Am 1998;80:1020–33.

    Article  CAS  Google Scholar 

  12. Burgert EO Jr, Nesbit ME, Garnsey LA, Gehan EA, Herrmann J, Vietti TJ, et al. Multimodal therapy for the management of nonpelvic, localized Ewing’s sarcoma of bone: Intergroup study IESS-II. J Clin Oncol 1990;8:1514–24.

    Article  Google Scholar 

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Correspondence to Anshu Shekhar.

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Shekhar, A., Korlhalli, S. & Murgod, G. Ewing’s sarcoma of proximal phalanx of the hand with skip metastases to metacarpals. IJOO 49, 365–368 (2015). https://doi.org/10.4103/0019-5413.156229

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  • DOI: https://doi.org/10.4103/0019-5413.156229

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