Presentation
Right arm pain and swelling
Patient Data
Age: 20 years
Gender: Male
From the case:
Ewing sarcoma of humerus
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An elongated ill-defined permeative lesion associated with cortical thickening and lamellated periosteal reaction is noted at mid-diaphyseal region of right humerus. Mild soft tissue swelling is also noted. Findings are suggestive infective/ neoplastic lesion such as osteomyelitis or Ewing's sarcoma.
Case Discussion
Permeative nature, lamellated (onion-skin) periosteal reaction and diaphyseal location are characteristic of Ewing's sarcoma, with osteomyelitis being close differential on plain film.
MRI and nuclear scan of this patient were consistent with Ewing's sarcoma. Excision biopsy of right humeral lesion showed round blue cells compatible with Ewing's sarcoma.
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