Large retroperitoneal extraskeletal Ewing’s sarcoma with renal pedicle invasion: a case report
Abstract Background Extraskeletal Ewing’s sarcoma (EES) is a rare malignant tumor primarily found in children and young adults. Localized disease can present with nonspecific symptoms such as local mass, regional pain, and increased skin temperature. More severe cases may present with systemic sympt...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Urology |
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| Online Access: | https://doi.org/10.1186/s12894-023-01272-z |
| _version_ | 1797822619807907840 |
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| author | Shu-Yu Wu Chun-Kai Hsu Chung-Tai Yue Yao-Chou Tsai |
| author_facet | Shu-Yu Wu Chun-Kai Hsu Chung-Tai Yue Yao-Chou Tsai |
| author_sort | Shu-Yu Wu |
| collection | DOAJ |
| description | Abstract Background Extraskeletal Ewing’s sarcoma (EES) is a rare malignant tumor primarily found in children and young adults. Localized disease can present with nonspecific symptoms such as local mass, regional pain, and increased skin temperature. More severe cases may present with systemic symptoms such as malaise, weakness, fever, anemia, and weight loss. Among these lesions, retroperitoneal sarcomas are relatively uncommon and difficult to diagnose. Since they are usually asymptomatic until large enough to compress or invade the surrounding tissues, most are already advanced at first detection. Traditionally, the treatment of choice is complete surgical resection, sometimes combined with postoperative radiotherapy and chemotherapy. We report a case of EES with left renal artery invasion in the left retroperitoneal cavity successfully treated with transarterial embolization and surgery. Case presentation A 57-year-old woman with a negative family history of cancer presented at our Urology Department with a large left retroperitoneal tumor found by magnetic resonance imaging during the health exam. Physical examination showed a soft abdomen and no palpable mass or tenderness. Imaging studies showed that the tumor covered the entire left renal pedicle, but the left kidney, left adrenal gland, and pancreas appeared tumor free. Since the tumor tightly covered the entire renal pedicle, tumor excision with radical nephrectomy was advised. The patient underwent transarterial embolization of the left renal artery with 10 mg of Gelfoam pieces daily before surgical excision. Tumor excision and left radical nephrectomy were uneventful the day after embolization. Post-operatively, the patient recovered well and was discharged on day 10. The final histopathological analysis showed a round blue cell tumor consistent with an Ewing sarcoma, and the surgical margins were tumor free. Conclusions Retroperitoneal malignancies are rare but usually severe conditions. Our case report showed that retroperitoneal EES with renal artery invasion could be treated safely with transarterial embolization and surgery. |
| first_indexed | 2024-03-13T10:11:48Z |
| format | Article |
| id | doaj.art-adc46a41b71048d7b71f777d2f784565 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-03-13T10:11:48Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-adc46a41b71048d7b71f777d2f7845652023-05-21T11:28:23ZengBMCBMC Urology1471-24902023-05-012311610.1186/s12894-023-01272-zLarge retroperitoneal extraskeletal Ewing’s sarcoma with renal pedicle invasion: a case reportShu-Yu Wu0Chun-Kai Hsu1Chung-Tai Yue2Yao-Chou Tsai3Department of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDepartment of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDepartment of Pathology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationDepartment of Urology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical FoundationAbstract Background Extraskeletal Ewing’s sarcoma (EES) is a rare malignant tumor primarily found in children and young adults. Localized disease can present with nonspecific symptoms such as local mass, regional pain, and increased skin temperature. More severe cases may present with systemic symptoms such as malaise, weakness, fever, anemia, and weight loss. Among these lesions, retroperitoneal sarcomas are relatively uncommon and difficult to diagnose. Since they are usually asymptomatic until large enough to compress or invade the surrounding tissues, most are already advanced at first detection. Traditionally, the treatment of choice is complete surgical resection, sometimes combined with postoperative radiotherapy and chemotherapy. We report a case of EES with left renal artery invasion in the left retroperitoneal cavity successfully treated with transarterial embolization and surgery. Case presentation A 57-year-old woman with a negative family history of cancer presented at our Urology Department with a large left retroperitoneal tumor found by magnetic resonance imaging during the health exam. Physical examination showed a soft abdomen and no palpable mass or tenderness. Imaging studies showed that the tumor covered the entire left renal pedicle, but the left kidney, left adrenal gland, and pancreas appeared tumor free. Since the tumor tightly covered the entire renal pedicle, tumor excision with radical nephrectomy was advised. The patient underwent transarterial embolization of the left renal artery with 10 mg of Gelfoam pieces daily before surgical excision. Tumor excision and left radical nephrectomy were uneventful the day after embolization. Post-operatively, the patient recovered well and was discharged on day 10. The final histopathological analysis showed a round blue cell tumor consistent with an Ewing sarcoma, and the surgical margins were tumor free. Conclusions Retroperitoneal malignancies are rare but usually severe conditions. Our case report showed that retroperitoneal EES with renal artery invasion could be treated safely with transarterial embolization and surgery.https://doi.org/10.1186/s12894-023-01272-zRetroperitoneal tumorExtraskeletal Ewing’s sarcomaTransarterial embolization |
| spellingShingle | Shu-Yu Wu Chun-Kai Hsu Chung-Tai Yue Yao-Chou Tsai Large retroperitoneal extraskeletal Ewing’s sarcoma with renal pedicle invasion: a case report BMC Urology Retroperitoneal tumor Extraskeletal Ewing’s sarcoma Transarterial embolization |
| title | Large retroperitoneal extraskeletal Ewing’s sarcoma with renal pedicle invasion: a case report |
| title_full | Large retroperitoneal extraskeletal Ewing’s sarcoma with renal pedicle invasion: a case report |
| title_fullStr | Large retroperitoneal extraskeletal Ewing’s sarcoma with renal pedicle invasion: a case report |
| title_full_unstemmed | Large retroperitoneal extraskeletal Ewing’s sarcoma with renal pedicle invasion: a case report |
| title_short | Large retroperitoneal extraskeletal Ewing’s sarcoma with renal pedicle invasion: a case report |
| title_sort | large retroperitoneal extraskeletal ewing s sarcoma with renal pedicle invasion a case report |
| topic | Retroperitoneal tumor Extraskeletal Ewing’s sarcoma Transarterial embolization |
| url | https://doi.org/10.1186/s12894-023-01272-z |
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