Molecular Confirmation of Ewing Sarcoma in an 85-Year-Old Woman

Michael J. Monument, Allie H. Grossmann, Christine C. Baker, R Randall, Ting Liu, Daniel J. Albertson

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

We report a case of a Ewing sarcoma/primitive neuroectodermal tumor in an 85-year-old woman who presented with an enlarging circumscribed left flank mass. Magnetic resonance imaging revealed a 3 × 5 × 10 cm heterogeneous mass arising from the 10th rib. Computed tomography demonstrated a small nodule in the right middle lobe and bilateral pleural effusions. The patient underwent computed tomography-guided biopsy followed by open biopsy. The tumor cells were characterized by loosely cohesive sheets of tumor cells with uniform nuclei, and scant, granular, eosinophilic cytoplasm with indistinct cell membranes. Frequent mitoses, apoptosis, and necrosis were present. The cells were positive for CD99 with a strong concentric staining pattern. Epithelial, hematopoietic, and neural markers were all negative. Fluorescence in situ hybridization was performed and demonstrated EWSR1 (22q12) gene rearrangement. Sanger sequencing of the reverse transcriptase polymerase chain reaction product from the patients tumor demonstrated the EWSR1-FLI1 type 1 fusion. Following diagnosis the patient elected to proceed with localized radiation and declined chemotherapy. She developed progressive lung disease and subsequently died of her disease a year after her initial diagnosis. Ewing sarcoma is predominantly a pediatric disease and uncommon in patients older than 40 years of age. To the best of our knowledge, this is the oldest documented case of Ewing sarcoma, diagnosed using modern molecular techniques.

Original languageEnglish (US)
Pages (from-to)500-504
Number of pages5
JournalInternational Journal of Surgical Pathology
Volume23
Issue number6
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

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Ewing's Sarcoma
Tomography
Biopsy
Primitive Neuroectodermal Tumors
Neoplasms
Gene Rearrangement
Ribs
Pleural Effusion
Reverse Transcriptase Polymerase Chain Reaction
Fluorescence In Situ Hybridization
Mitosis
Lung Diseases
Cytoplasm
Necrosis
Magnetic Resonance Imaging
Cell Membrane
Radiation
Pediatrics
Apoptosis
Staining and Labeling

Keywords

  • Ewing sarcoma
  • EWS/FLI-1
  • fluorescent in situ hybridization
  • RT-PCR

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

Molecular Confirmation of Ewing Sarcoma in an 85-Year-Old Woman. / Monument, Michael J.; Grossmann, Allie H.; Baker, Christine C.; Randall, R; Liu, Ting; Albertson, Daniel J.

In: International Journal of Surgical Pathology, Vol. 23, No. 6, 01.01.2015, p. 500-504.

Research output: Contribution to journalArticle

Monument, Michael J. ; Grossmann, Allie H. ; Baker, Christine C. ; Randall, R ; Liu, Ting ; Albertson, Daniel J. / Molecular Confirmation of Ewing Sarcoma in an 85-Year-Old Woman. In: International Journal of Surgical Pathology. 2015 ; Vol. 23, No. 6. pp. 500-504.
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