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February 6, 2026Respirology Case Reports0 citationsOpen Access

Adult‐Onset Primary Pleura Ewing Sarcoma With Recurrent Pleural Effusion: A Case Report and Literature Review

HKHamza Khan KhattakKhyber Medical CollegeLMLaiba Urooj MalikShaheed Mohtarma Benazir Bhutto Medical UniversityZKZia Ullah KhanAyub Medical College

Key Result

Multi-agent VAC/IE chemotherapy in a 42-year-old woman with rare pleural extraskeletal Ewing sarcoma did not prevent an aggressive disease course, and the patient succumbed during follow-up.

Key Points

  • To report a rare case of pleural extraskeletal Ewing sarcoma and review existing literature to enhance understanding of its characteristics.
  • Case report of a 42-year-old woman
  • Assessment through physical examination, ultrasound, and CT scans
  • Biopsy performed to confirm diagnosis
  • Treatment with multi-agent VAC/IE chemotherapy
  • Patient presented with chest pain and low-grade fever, indicating disease progression.
  • Right-sided pleural effusion detected via ultrasound, complicating diagnosis.
  • Multiple pulmonary nodules identified by CT scans.
  • Despite chemotherapy, the disease progressed aggressively, resulting in the patient's demise.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
1 adult (42-year-old woman) with primary pleural Extraskeletal Ewing sarcoma presenting with recurrent pleural effusion
I
Intervention
Multi-agent VAC/IE chemotherapy (vincristine, doxorubicin, cyclophosphamide, etoposide, ifosfamide, and prednisone) and pleurodesis with talc powder
O
Outcome
Disease course and survivalhard clinical

Primary pleural extraskeletal Ewing sarcoma is a rare, aggressive malignancy that can present as recurrent pleural effusion and requires prompt tissue biopsy for diagnosis.

Abstract

ABSTRACT Extraskeletal Ewing sarcoma (EES) is a rare malignant tumour within the “Ewing family of tumours,” first described by Tefft et al. in 1969. It accounts for less than 1 case per million, typically affecting adolescents and young adults. We report a rare case of pleural EES in a 42‐year‐old woman presenting with chest pain and low‐grade fever persisting for one month. Physical examination showed decreased breath sounds in the right lung base on auscultation. Ultrasound demonstrated right‐sided pleural effusion, an unusual manifestation of EES that can hinder accurate diagnosis. CT scans identified multiple pulmonary nodules, further confirmed by thoracoscopy. Biopsy established the diagnosis of EES. The patient was subsequently treated with multi‐agent VAC/IE chemotherapy. Despite initiation of systemic therapy, the disease followed an aggressive course, and the patient succumbed during follow‐up. We also review existing literature to highlight clinical, pathological, and radiological features of pleural EES, aiming to expand knowledge of this rare presentation.

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Cite This Study

Khattak et al. (2026) conducted a case report in Pleural Extraskeletal Ewing sarcoma (EES) (n=1). Multi-agent VAC/IE chemotherapy was evaluated. Multi-agent VAC/IE chemotherapy in a 42-year-old woman with rare pleural extraskeletal Ewing sarcoma did not prevent an aggressive disease course, and the patient succumbed during follow-up.

synapsesocial.com/papers/698586238f7c464f2300a0e9https://doi.org/10.1002/rcr2.70498
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