A case of large pelvic Ewing sarcoma family of tumors successfully treated with high-dose chemotherapy and radiotherapy without surgical resection

Abstract

A 10-year-old girl with lumber pain and right leg pain persisting for six months gradually became unable to walk and visited our hospital. X-ray examination showed a permeative lytic lesion with periosteal reaction in the right iliac bone. On MRI, the large right iliac bone mass invaded the retroperitoneal cavity, gluteus muscles, and sacrum. The mass was diagnosed as Ewing sarcoma family of tumors on the basis of biopsy findings. Surgical resection with a safety margin was difficult owing to the extensive invasion of the mass. She was treated with five cycles of chemotherapy with vincristine, pirarubicin, cyclophosphamide, etoposide, and ifosfamide, high-dose chemotherapy with melphalan, etoposide, and carboplatin, followed by autologous peripheral blood stem cell transplantation and local radiotherapy without resection, and she achieved complete remission. Endocrine and growth disorders were observed as late complications; however, the sarcoma did not relapse seven years after treatment. If surgical resection is difficult to perform, high-dose chemotherapy can be effective for Ewing sarcoma treatment.