Published online May 26, 2024. doi: 10.12998/wjcc.v12.i15.2606
Revised: March 6, 2024
Accepted: April 7, 2024
Published online: May 26, 2024
Processing time: 127 Days and 3.4 Hours
Ewing’s sarcoma (ES) is a neuroectodermal tumor that typically occurs in the bones and soft tissues of children and young adults. Primary renal ES is rare; only a few cases and a small case series have been documented, and only four cases involved primary renal ES in older people (> 65 years old).
Herein, we describe the radiological and pathological features of primary renal ES in an older person. A 76-year-old man complained of poor oral intake and was found to have a large cystic renal mass with indistinct margins on computed tomography. Ultrasound-guided biopsy revealed that the tumor contained small round blue cells. The patient underwent a right radical nephrectomy. The tumor cells showed diffuse membranous CD99, and nuclear friend leukemia integration 1 transcription factor and NK2 Homeobox 2. Fluorescence in situ hybridization revealed EWSR1 translocation. Postoperatively, 18F-fluorodeoxyglucose positron emission tomography revealed no evidence of metastasis. The patient was diagnosed with primary renal ES. Six months following the surgery, local recurrence and distant metastasis were observed. Primary renal ES is rare and often lethal in older individuals. The specific imaging findings are unknown, and treatment protocols have not been standardized.
This case report describes the radiological and pathological features of primary renal ES in an older person.
Core Tip: Primary renal Ewing’s sarcoma (ES) is extremely rare, whereas shown aggressive radiological features and poor outcome. It is important to consider primary renal ES in the differential diagnosis when renal mass shown indistinctive margin and necrosis/hemorrhage in older patients. Primary renal ES undergo surgical resection and receive adjuvant chemotherapy. Moreover, radiation therapy is efficient for local recurrence.