A Case of Primary Ewing's Sarcoma of the Jejunum Presenting with Small Intestinal Obstruction

Abstract

A 43-year-old man presented to our hospital with a complaint of abdominal distention for 2 days. He underwent partial resection of the small intestine 13 days later with a diagnosis of neoplastic bowel obstruction. Postoperative histopathological examination showed Ewing's sarcoma (ES). One month after surgery, peritoneal dissemination was found, and the tumor grew to about 14 × 8 cm, causing abdominal distention. Chemoradiotherapy was recommended to the patient, but he chose only symptomatic treatment. Palliative radiotherapy was administered, and abdominal computed tomography showed a decrease in the size of the tumor. The patient is still alive 6 months after surgery and attends as an outpatient. This was a case of primary ES of the jejunum that presented with small intestinal obstruction. ES is a malignant tumor that develops in bone and soft tissue in children and young adults, and primary intra-abdominal organ ES is rare. A literature search identified only 13 cases reported in Japan. To the best of our knowledge, this is the first report of successful palliative radiotherapy for a patient with primary intra-abdominal ES, and it is described along with a review of the literature.