Ewing’s Sarcoma/Pnet Presenting as Breast Mass by Pallavi Mishra in BJSTR

Ewing’s Sarcoma/Pnet Presenting as Breast Mass by Pallavi Mishra in BJSTR

Abstract

Introduction: Ewing’s sarcoma family of tumours (ESFT) are uncommon, aggressive malignant tumours that usually arise in soft tissues or bones in children and young adults. Long bones of the lower limbs are most commonly involved. Occurrence at atypical sites can pose a diagnostic challenge. We report an exceptional case of this tumour presenting as a breast mass in a male patient.

Case Report: A 23-year-old male patient was referred to our centre with complaint of a progressively enlarging breast lump. This was initially suspected to be carcinoma, breast. On re-evaluation at our centre, FNAC yielded a diagnosis of small round cell malignancy and a possibility of Ewing’s/PNET was suggested which was confirmed on trucut biopsy and immune histochemistry. Chest CT scan subsequently performed revealed a left sided heterogeneous soft tissue mass involving a large part of thorax, causing contra lateral meditational shift. Understanding the nature and extent of disease and expecting a dismal outcome the patient refused any further investigation and treatment.

Discussion: ESFT are aggressive fast growing tumours which require urgent diagnosis for swift commencement of therapy. Occurrence at unusual sites or uncommon presentations can lead to consideration of alternative clinical diagnoses and make the evaluation challenging. This case highlights the need for careful evaluation of cytology smears, keeping in mind the unexpected, avoiding the unnecessary diagnostic delay.

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