Ewing’s sarcoma of proximal humerus: A rare case report

Abstract

Ewing’s sarcoma is a highly malignant small round cell tumor from bone or soft tissue. The clinical manifestation is non-specific, with local pain being the most common symptom by far. It affects prevalently among children younger than ten years. The chromosomal translocation t(11;22)(q24:q12) is one of the causes of Ewing’s sarcoma. The gold standard diagnostic is incisional biopsy, additionally with cytogenic immunohistochemical. The current standard treatment for resectable Ewing’s sarcoma begins with neoadjuvant chemotherapy, followed by limb salvage procedure and postoperative adjuvant chemotherapy. After resection of Ewing’s sarcoma, the large bone defects should be reconstructed to restore the function of the affected limbs. The main options for reconstruction include autogenous bone grafts and endoprosthesis. Prognosis of Ewing’s sarcoma is highly dependent on clinically evident metastatic disease, which may be preventable with early detection and treatment with aggressive local disease control and systemic multidrug chemotherapy. This article presents a rare case of an 8-year-old elementary schoolboy, diagnosed with Ewing’s sarcoma of the proximal left humerus that was confirmed by plain radiograph and immunohistochemical biopsy. Patient’s family discontinued the chemotherapy schedule and ignored the surgical reconstruction procedure.