Ewings sarcoma of femur in a 15-yr-old: a case report
The present case has been reported in the journal Imaging in Medicine.

A 15 year old male patient, presented with a firm, tender swelling of the left thigh. However, there was no restriction of movement of the knee joint. He was febrile and white blood cell counts were raised. However, X-ray chest and ESR were normal. The patient was referred to the department of radiodiagnosis for ultrasonography of left thigh to rule out any abscess formation.

Ultrasound was done with a linear probe at 12 MHz. A large heterogeneously hypoechoiec mass was seen in the region of the swelling. Sunray type of appearance was seen arising from the femur within the soft tissue – suggestive of sunray –type periosteal reaction. Increased vascularity was noted within the soft tissue mass on Color Doppler. A provisional diagnosis of Ewing’s sarcoma or Osteosarcoma was given.

AP and lateral radiographs of left femur with knee revealed permeative pattern of bone destruction involving the distal metadiaphysial region. Periosteal reaction with typical Codman’s triangle appearance with sunburst pattern was seen.

Biopsy from the mass was done and it showed sheets of round to oval cells with scant cytoplasm and hyperchromatic nuclei. Vague rosettes were seen. On IHC, tumor cells expressed FLI-1, vimentin, CD-99 and synaptophysin. Diagnosis of Ewing’s sarcoma of the left femur was made.

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