Angela Tamburini, Giovanni Beltrami, Perla Scalini, Marina Vignoli, Lara Perrone, Stefania Cardellicchio, Marinella Veltroni, Annamaria Buccoliero, Cecilia Cecchi, Tommaso Casini, Maura Calvani and Claudio Favre
Ewing's sarcoma (ES) is an uncommon malignancy of childhood and adults that constitutes 6%-8% of all primary malignant tumors and the third-most common tumor after osteosarcoma and chondrosarcoma. This article presents a case of localized ES iliac wing in a 12-year-old male patient, treated in accord to the ISG-EW1 protocol, showing extensive percentage of circulating tumor cells if compared with other non-metastatic patients, which is not a frequent presentation. Histopathological needle biopsy from the soft tissue extension of the tumor revealed small round-cell tumor with strong CD99 positivity, supporting the diagnosis of Ewing's sarcoma. The diagnosis was confirmed by reciprocal translocation of chromosomes 11 and 22. Analysis of tumor circulating cells revealed a massive percentage of tumor cell in peripheral blood, comparable to the levels that usually were found in metastatic patient.
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