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Int J Surg Pathol ; 29(7): 798-803, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33703949

RESUMEN

Adamantinoma-like Ewing sarcoma is a rare variant of Ewing sarcoma with histologic and immunohistochemical evidence of squamous differentiation. This variant most commonly occurs in the head and neck region with a few cases reported in the long bones of the limbs. It may be associated with poorer clinical outcome and could pose a diagnostic challenge, particularly if it occurs in older patients or as a metastatic lesion. We present a case of Ewing sarcoma in the metatarsal of an 11-year-old boy that manifested adamantinoma-like morphology after neoadjuvant chemotherapy. Chemotherapy has been reported to induce neuronal maturation and rhabdoid morphology in cases of Ewing sarcoma, but no reports of treatment-induced squamous differentiation with P40/P63 expression have been demonstrated. This is also the first documented case treated with a pedicled osteocutaneous fibular transfer in a metatarsal malignancy, which is usually treated by either ray or below-knee amputation.


Asunto(s)
Adamantinoma/diagnóstico , Neoplasias Óseas/diagnóstico , Huesos Metatarsianos/patología , Terapia Neoadyuvante/efectos adversos , Sarcoma de Ewing/diagnóstico , Adamantinoma/inducido químicamente , Adamantinoma/patología , Adamantinoma/cirugía , Neoplasias Óseas/inducido químicamente , Neoplasias Óseas/patología , Neoplasias Óseas/terapia , Quimioradioterapia Adyuvante/efectos adversos , Quimioradioterapia Adyuvante/métodos , Niño , Peroné/trasplante , Humanos , Imagen por Resonancia Magnética , Masculino , Huesos Metatarsianos/diagnóstico por imagen , Huesos Metatarsianos/cirugía , Terapia Neoadyuvante/métodos , Sarcoma de Ewing/patología , Sarcoma de Ewing/terapia , Colgajos Quirúrgicos/trasplante , Resultado del Tratamiento
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