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KMID : 0858520170210010051
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Journal of the Korean Society of Magnetic Resonance in Medicine
2017 Volume.21 No. 1 p.51 ~ p.55
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Extraosseous Ewing's Sarcoma Presented as a Rectal Subepithelial Tumor: Radiological and Pathological Features
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Bae Hee-Jin
Chung Taek
Park Mi-Suk
Kim Myeong-Jin
Lim Joon-Seok
Kim Hon-Soul
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Abstract
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Purpose: Extraosseous Ewing's sarcoma (EOE) of the rectum is extremely rare: only three cases have been reported in the literature and none of these reports described their imaging findings in detail. Herein, we describe the tumor imaging and pathological features in detail.
Materials and Methods: We report a case of rectal EOE in a 72-year-old female who received local excision and was provisionally diagnosed with a rectal submucosal spindle cell tumor. We used immunohistochemistry, histopathology, and fluorescence in situ hybridization to characterize the tumor and provide a definitive diagnosis of EOE.
Results: MRI revealed a well-demarcated submucosal tumor with heterogeneous enhancement and hemorrhagic foci in rectum. EOE was diagnosed by positive staining of tumor cells for CD99 and Fli-1 by immunohistochemistry and the presence of the EWSR1 gene translocation by fluorescence in situ hybridization. Although the patient underwent radiation treatment and surgery, the tumor recurred after 4 months as revealed by computed tomography and magnetic resonance imaging.
Conclusion: Rectal EOE may present as a rectal submucosal tumor. The understanding of imaging and histological characteristics of this tumor are critical for accurate diagnosis and appropriate aggressive treatment.
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KEYWORD
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Ewing's Sarcoma, Extraosseous Ewing's Sarcoma, Rectal submucosal tumor, Rectal MRI
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