Key result
An EWSR1::NFATC2 gene fusion was identified in an older adult with an adamantinoma-like Ewing sarcoma neck mass, representing a rare presentation of this malignancy.
Why the study?
Adamantinoma-like Ewing sarcoma is exceptionally rare in older adults, and cases with EWSR1::NFATC2 gene fusions present significant diagnostic and multidisciplinary management challenges.
Reports a rare case of Adamantinoma-like Ewing sarcoma with EWSR1::NFATC2 gene fusion in an older adult, highlighting diagnostic challenges.
Highlights diagnostic challenges in elderly neck masses; extends spectrum of EWSR1::NFATC2-rearranged sarcomas.
Ewing sarcoma (ES) and its variants are rare and aggressive malignancies, occurring in paediatric and younger adult populations. Adamantinoma-like ES (ALES) is one of its variants, characterised by EWSR1::FLI1 fusions, and is exceptionally rare, especially in older adults. There are a few similar cases reported in the literature. We report a rare case of an older adult with a complicated medical history and reported a left neck mass on a follow-up visit; the mass developed over nine months. After evaluation, he was found to have a rare diagnosis of ALES in this age group, specifically with this Ewing Sarcoma RNA binding protein 1 and nuclear factor of activated T cells cytoplasmic 2 ( EWSR1::NFATC2 ) gene fusion. This case highlights the challenges of diagnosing and the multidisciplinary management of rare variants of ES with uncommon gene fusions and raises awareness for the future potential of molecular diagnostics and treatment-specific applications for improved access to care and better outcomes for this population.
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Faquih et al. (2026) studied this question. An EWSR1::NFATC2 gene fusion was identified in an older adult with an adamantinoma-like Ewing sarcoma neck mass, representing a rare presentation of this malignancy.
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