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Extraskeletal Ewing sarcoma presenting as an axillary mass with pulmonary metastases
  1. James R Marak1,
  2. Neha Singh2,
  3. Swasti Pathak1 and
  4. Namrata P Awasthi3
  1. 1Radiodiagnosis, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  2. 2Radiodiagnosis & Imaging, CSMMU, Lucknow, India
  3. 3Pathology, Dr Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr James R Marak; jamesmarak93{at}


Extraskeletal Ewing sarcoma (EES) is a tumour of rare variant of the Ewing sarcoma family of tumours. This family of tumours can have different features; however, these tumours are categorised on the basis of genetic translocation, specific molecular and immunohistochemical features. EES is seen commonly affecting young adults with poor prognosis and high mortality rates. It can be detected in various locations making its diagnosis more difficult. It can present with varied imaging features, often non-specific. However, imaging plays a vital role in the primary tumour assessment, local staging, preoperative management and surveillance. Management involves surgery with chemotherapy. Long-term prognosis in cases of metastatic disease is very poor. In literature, only three cases of axillary EES have been reported so far. Here, we report the fourth case of large EES originating in the left axillary region in a woman in her 20s. The patient was given neoadjuvant chemotherapy; however, the size of the tumour increased, which was later surgically treated with complete excision of the tumour. Unfortunately, the tumour metastasised to the lung for which the patient was irradiated. Afterwards, the patient presented to the emergency room with respiratory distress for which she was on ventilator support; sadly, the patient died after 1 week.

  • Radiology
  • Oncology
  • Radiotherapy
  • Pathology

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  • Contributors JRM wrote the manuscript under the guidance of NS who gave instructions in editing, formulating and properly directing the manuscript. SP edited the images and labelled the legends. NPA made the diagnosis on histopathology and formulated the histopathology images and labelled them.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • © BMJ Publishing Group Limited 2023. No commercial re-use. See rights and permissions. Published by BMJ.