Extraosseous Ewing sarcoma presenting as recurrent intergluteal pilonidal disease
Abstract Background Pilonidal disease classically presents as an abscess or soft tissue swelling which classically occurs in the intergluteal cleft, just above the anus. Risk factors for this disease include obesity, prolonged sitting, and abundance of gluteal hair. Treatment options are extensive b...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-12-01
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| Series: | Annals of Pediatric Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43159-020-00065-5 |
| _version_ | 1818611452799352832 |
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| author | Marisa A. Sewell Frieda M. Hulka Jacob P. Zucker |
| author_facet | Marisa A. Sewell Frieda M. Hulka Jacob P. Zucker |
| author_sort | Marisa A. Sewell |
| collection | DOAJ |
| description | Abstract Background Pilonidal disease classically presents as an abscess or soft tissue swelling which classically occurs in the intergluteal cleft, just above the anus. Risk factors for this disease include obesity, prolonged sitting, and abundance of gluteal hair. Treatment options are extensive but most often include incision and drainage with antibiotic treatment. Presentation of recurrent intergluteal pilonidal disease in a young, active female would then be unusual. We present a case of a 17-year-old female presenting with what appeared to be intergluteal pilonidal disease. Definitive excision with histopathology revealed a diagnosis of extraosseous Ewing sarcoma. Case presentation An otherwise healthy and active 17-year-old female presented to our Pediatric Oncology clinic with a 2-month history of recurrent painful soft tissue swelling of the intergluteal cleft. At that time, she had been diagnosed with pilonidal abscess and had already undergone three incision and drainage procedures. A definitive excision with pathology was performed within weeks of her initial presentation. Immunohistochemical evaluation confirmed a diagnosis of extraosseous Ewing sarcoma. Conclusion This unusual case underlies the importance of considering a broad differential when evaluating potential pilonidal abscess in a patient who otherwise has no risk factors. Additionally, definitive excision with pathology is critical in a patient with unusually recurrent disease as this can be crucial in the identification of an alternative, and potentially devastating, diagnosis. |
| first_indexed | 2024-12-16T15:30:34Z |
| format | Article |
| id | doaj.art-0f57ff8092ee4b01b0bac7f0fabd8e18 |
| institution | Directory Open Access Journal |
| issn | 2090-5394 |
| language | English |
| last_indexed | 2024-12-16T15:30:34Z |
| publishDate | 2020-12-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Annals of Pediatric Surgery |
| spelling | doaj.art-0f57ff8092ee4b01b0bac7f0fabd8e182022-12-21T22:26:21ZengSpringerOpenAnnals of Pediatric Surgery2090-53942020-12-011611310.1186/s43159-020-00065-5Extraosseous Ewing sarcoma presenting as recurrent intergluteal pilonidal diseaseMarisa A. Sewell0Frieda M. Hulka1Jacob P. Zucker2School of Medicine, University of Nevada RenoDepartment of Surgery, School of Medicine, University of Nevada RenoDepartment of Pediatric Hematology/Oncology, Renown Health Children’s HospitalAbstract Background Pilonidal disease classically presents as an abscess or soft tissue swelling which classically occurs in the intergluteal cleft, just above the anus. Risk factors for this disease include obesity, prolonged sitting, and abundance of gluteal hair. Treatment options are extensive but most often include incision and drainage with antibiotic treatment. Presentation of recurrent intergluteal pilonidal disease in a young, active female would then be unusual. We present a case of a 17-year-old female presenting with what appeared to be intergluteal pilonidal disease. Definitive excision with histopathology revealed a diagnosis of extraosseous Ewing sarcoma. Case presentation An otherwise healthy and active 17-year-old female presented to our Pediatric Oncology clinic with a 2-month history of recurrent painful soft tissue swelling of the intergluteal cleft. At that time, she had been diagnosed with pilonidal abscess and had already undergone three incision and drainage procedures. A definitive excision with pathology was performed within weeks of her initial presentation. Immunohistochemical evaluation confirmed a diagnosis of extraosseous Ewing sarcoma. Conclusion This unusual case underlies the importance of considering a broad differential when evaluating potential pilonidal abscess in a patient who otherwise has no risk factors. Additionally, definitive excision with pathology is critical in a patient with unusually recurrent disease as this can be crucial in the identification of an alternative, and potentially devastating, diagnosis.https://doi.org/10.1186/s43159-020-00065-5Ewing sarcomaPilonidal diseaseAbscess |
| spellingShingle | Marisa A. Sewell Frieda M. Hulka Jacob P. Zucker Extraosseous Ewing sarcoma presenting as recurrent intergluteal pilonidal disease Annals of Pediatric Surgery Ewing sarcoma Pilonidal disease Abscess |
| title | Extraosseous Ewing sarcoma presenting as recurrent intergluteal pilonidal disease |
| title_full | Extraosseous Ewing sarcoma presenting as recurrent intergluteal pilonidal disease |
| title_fullStr | Extraosseous Ewing sarcoma presenting as recurrent intergluteal pilonidal disease |
| title_full_unstemmed | Extraosseous Ewing sarcoma presenting as recurrent intergluteal pilonidal disease |
| title_short | Extraosseous Ewing sarcoma presenting as recurrent intergluteal pilonidal disease |
| title_sort | extraosseous ewing sarcoma presenting as recurrent intergluteal pilonidal disease |
| topic | Ewing sarcoma Pilonidal disease Abscess |
| url | https://doi.org/10.1186/s43159-020-00065-5 |
| work_keys_str_mv | AT marisaasewell extraosseousewingsarcomapresentingasrecurrentinterglutealpilonidaldisease AT friedamhulka extraosseousewingsarcomapresentingasrecurrentinterglutealpilonidaldisease AT jacobpzucker extraosseousewingsarcomapresentingasrecurrentinterglutealpilonidaldisease |