Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2024; 12(23): 5431-5440
Published online Aug 16, 2024. doi: 10.12998/wjcc.v12.i23.5431
Cushing's syndrome caused by giant Ewing's sarcoma of the kidney: A case report and review of literature
Guo-Fan Dong, Ya-Kun Hou, Qi Ma, Shuang-Yu Ma, Yu-Jie Wang, Mulati Rexiati, Wen-Guang Wang
Guo-Fan Dong, Ya-Kun Hou, Qi Ma, Shuang-Yu Ma, Yu-Jie Wang, Mulati Rexiati, Wen-Guang Wang, Department of Urologic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830000, Xinjiang Uygur Autonomous Region, China
Co-first authors: Guo-Fan Dong and Ya-Kun Hou.
Author contributions: Dong GF and Hou YK wrote the main manuscript text, contributed equally to this paper; Ma Q and Ma SY prepared the figures. Wang YJ and Rexiati M were responsible for conceptualization and supervision; Wang WG was responsible for supervision and replied to peer review. All the authors reviewed their participation in the treatment and reviewed the manuscript.
Informed consent statement: The use of human blood samples was in accordance with the legislation in China. Informed consent was obtained from the relatives of the patient. Written informed consent was obtained from the patient's relatives for the publication of this case report and any accompanying images.
Conflict-of-interest statement: We declare that there are no conflicts of interest between the authors.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Guang Wang, MD, Associate Professor, Chief Doctor, Surgeon, Department of Urologic Surgery, The First Affiliated Hospital of Xinjiang Medical University, No. 137 Liyu Shan South Road, High-tech Zone, Urumqi 830000, Xinjiang Uygur Autonomous Region, China. wwg0903@163.com
Received: April 14, 2024
Revised: June 6, 2024
Accepted: June 26, 2024
Published online: August 16, 2024
Processing time: 81 Days and 20.4 Hours
Abstract
BACKGROUND

Primary renal Ewing’s sarcoma (ES) is extremely rare, and only two cases causing Cushing’s syndrome (CS) have been reported to date. We report that the case of an 18-year-old patient is diagnosed primary renal ES with typical CS characterized by purple stripes, weight gain, and hypertension.

CASE SUMMARY

CS was first diagnosed by laboratory testing. A huge tumor was revealed in the kidney following an imaging examination. Moreover, brain and bone metastases were observed. After comprehensive treatment, primarily based on surgery, primary renal ES was pathologically diagnosed with a typical EWSR1-FLI1 genetic mutation through genetic testing. Furthermore, the glucocorticoid level returned to normal. By the ninth postoperative month of follow-up, the patient was recovering well. Cushing-related symptoms had improved, and a satisfactory curative effect was achieved.

CONCLUSION

Primary renal ES, a rare adult malignant tumor, can cause CS and a poor prognosis.

Keywords: Renal, Kidney, Ewing's sarcoma, Neuroectodermal tumors, Cushing syndrome, Case report

Core Tip: Primary renal Ewing's sarcoma (ES), a rare adult malignant tumor, can cause Cushing syndrome and a poor prognosis. The "gold standard" for diagnosing primary renal ES remains pathological examination, even though gene studies can aid in diagnosis and therapy planning. When treating advanced metastatic primary renal ES, a comprehensive surgical approach centered on surgery can produce specific outcomes.