Premium
Ganglion cells in Ewing's sarcoma following chemotherapy: A case report
Author(s) -
MAEDA GO,
MASUI FUMIAKI,
YOKOYAMA RYOHEI,
SHIMODA TADAKAZU,
MATSUNO YOSHIHIRO,
MUKAI KIYOSHI,
OHTOMO KATSUYUKI,
BEPPU YASUO,
FUKUMA HISATOSHL
Publication year - 1998
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.1998.tb03936.x
Subject(s) - synaptophysin , pathology , medicine , biopsy , enolase , ganglion , chemotherapy , autopsy , neurofilament , sarcoma , immunohistochemistry , anatomy , surgery
A case of Ewing's sarcoma of the bone, arising in the right radius of a 12‐year‐old girl, which showed unique histologic features after pre‐operative treatment, is reported. The light microscopic features of a biopsy sample were those of a small round cell tumor showing positive immunoreaction with antibodies against the product of the MIC 2 gene (O13), neuron‐specific enolase, neurofilament, and synaptophysin, but no morphological differentiation. The patient received combined intensive multi drug chemotherapy and radiation before surgery. Examination of the surgical specimen showed that the tumor was less cellular than that in the biopsy specimen, and was composed mainly of loosely textured large cells mimicking ganglion cells, occasionally forming Homer‐Wright rosettes. An lmmunohistochemical study revealed that neural differentiation was enhanced. Immunoreactivity for Leu‐7 also became positive. Although the patient underwent postoperative chemotherapy, she died of multiple lung and bone metastases 30 months alter the diagnosis. Autopsy showed that metastatic foci were made up of densely packed small round cells like those seen In the biopsy samples, but associated with prominent Homer‐Wright rosettes. To the authors' knowledge, this is the first report of a tumor being replaced almost entirely by ganglion cells after preoperative chemotherapy and radiotherapy.