Key result
Ewing sarcoma in patients aged ≥40 years predominantly arose at extraskeletal sites (41 of 50 cases) and showed unusual morphologic features, with 15 of 43 followed patients developing metastasis.
Why the study?
The clinicopathologic features of Ewing sarcoma presenting in older adulthood required exploration.
Observational (n=50)
Ewing sarcoma in older adults is rare, most often extraskeletal, and can show unusual morphologic features that mimic more common neoplasms in this age group.
Answers are grounded in this paper and cite their sources.
Alerts pathologists to Ewing sarcoma in atypical extraskeletal masses of older adults; leaves open optimal management strategies.
Objective. We explore the clinicopathologic features of Ewing sarcoma (ES) presenting in older adulthood. Methods. Cases of molecularly confirmed ES arising in patients aged ≥40 years were evaluated. Results. Fifty patients were identified (33 males/17 females; 41-86 years). The majority of tumors (41) arose at extraskeletal sites, while 9 were bone primaries. Twenty-eight cases showed nested architecture, while the remaining cases showed sheet-like growth. Tumor cytology was categorized as conventional (n = 39), crushed (n = 5), clear cell (n = 4), rhabdoid (n = 3), and epithelioid (n = 2). Fifty percent had necrosis, while rosettes were noted in 1 case. Immunostains performed ranged from 1 to 28 (median = 10). Follow-up (n = 43, 1-147 months) revealed 15 patients with metastasis. Conclusion. Although rare, ES should be considered in the differential diagnosis for round cell malignancies in older adult patients. In this cohort, ES is most often extraskeletal, and may show unusual morphologic features, closely simulating more common neoplasms in this age group.
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Jahanseir et al. (2019) conducted an observational in Ewing sarcoma (n=50). Ewing sarcoma was evaluated on Clinicopathologic features and metastasis. Ewing sarcoma in patients aged ≥40 years predominantly arose at extraskeletal sites (41 of 50 cases) and showed unusual morphologic features, with 15 of 43 followed patients developing metastasis.
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