Extraskeletal Ewing sarcoma of the duodenum presenting as duodenojejunal intussusception
Investigations showed a haemoglobin concentration of 8·1 g/dL, platelet count of 565 × 109 per L (normal 150–400), and white cell count of 10·5 × 109 per L; the mean corpuscular volume was 77·2 fL (normal 80–94) and the mean corpuscular haemoglobin was 23·1 pg per cell—suggestive of iron deficiency...
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Published in | The Lancet (British edition) Vol. 399; no. 10331; p. 1265 |
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Main Authors | , , , , , , , , , |
Format | Journal Article |
Language | English |
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England
Elsevier Ltd
26.03.2022
Elsevier Limited |
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Abstract | Investigations showed a haemoglobin concentration of 8·1 g/dL, platelet count of 565 × 109 per L (normal 150–400), and white cell count of 10·5 × 109 per L; the mean corpuscular volume was 77·2 fL (normal 80–94) and the mean corpuscular haemoglobin was 23·1 pg per cell—suggestive of iron deficiency anaemia. Immunohistochemistry stains demonstrated strong and diffuse nuclear immunoreactivity to NKX2-2 and ERG, with membranous immunoreactivity to CD99, and an absence of nuclear immunoreactivity to FLI1: supporting a possible fusion of the EWSRI gene on chromosome 22q12 with the gene encoding the transcription factor ERG (appendix). Young adults presenting with recurrent vomiting, weight loss, an abdominal mass, and anaemia should raise the suspicion of an aggressive malignancy (video). |
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AbstractList | Investigations showed a haemoglobin concentration of 8·1 g/dL, platelet count of 565 × 109 per L (normal 150–400), and white cell count of 10·5 × 109 per L; the mean corpuscular volume was 77·2 fL (normal 80–94) and the mean corpuscular haemoglobin was 23·1 pg per cell—suggestive of iron deficiency anaemia. Immunohistochemistry stains demonstrated strong and diffuse nuclear immunoreactivity to NKX2-2 and ERG, with membranous immunoreactivity to CD99, and an absence of nuclear immunoreactivity to FLI1: supporting a possible fusion of the EWSRI gene on chromosome 22q12 with the gene encoding the transcription factor ERG (appendix). Young adults presenting with recurrent vomiting, weight loss, an abdominal mass, and anaemia should raise the suspicion of an aggressive malignancy (video). |
Author | I-Vern, Lim Hean, Lim Choon Meng, Leow Voon Sankaran, Padmaan Dusa, Noraini Mohd Euxian, Lee Subramaniam, Manisekar Hassan, Razeen Mohamad, Haidi Ngee, Kee Thian |
Author_xml | – sequence: 1 givenname: Razeen surname: Hassan fullname: Hassan, Razeen organization: Department of Surgery, Ministry of Health, Kedah, Malaysia – sequence: 2 givenname: Leow Voon surname: Meng fullname: Meng, Leow Voon email: lvmeng74@gmail.com organization: Department of Surgery, Ministry of Health, Kedah, Malaysia – sequence: 3 givenname: Kee Thian surname: Ngee fullname: Ngee, Kee Thian organization: Department of Surgery, Ministry of Health, Kedah, Malaysia – sequence: 4 givenname: Lim surname: I-Vern fullname: I-Vern, Lim organization: Department of Surgery, Ministry of Health, Kedah, Malaysia – sequence: 5 givenname: Padmaan surname: Sankaran fullname: Sankaran, Padmaan organization: Department of Surgery, Ministry of Health, Kedah, Malaysia – sequence: 6 givenname: Lim Choon surname: Hean fullname: Hean, Lim Choon organization: Department of Surgery, Ministry of Health, Kedah, Malaysia – sequence: 7 givenname: Lee surname: Euxian fullname: Euxian, Lee organization: Department of Surgery, Ministry of Health, Kedah, Malaysia – sequence: 8 givenname: Haidi surname: Mohamad fullname: Mohamad, Haidi organization: Department of Pathology, Hospital Sultanah Bahiyah, Ministry of Health, Kedah, Malaysia – sequence: 9 givenname: Noraini Mohd surname: Dusa fullname: Dusa, Noraini Mohd organization: Department of Pathology, Hospital Kuala Lumpur, Ministry of Health, Malaysia – sequence: 10 givenname: Manisekar surname: Subramaniam fullname: Subramaniam, Manisekar organization: Department of Surgery, Ministry of Health, Kedah, Malaysia |
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SubjectTerms | Abdomen Anemia Computed tomography Duodenum Ewing's sarcoma Ewings sarcoma Hemoglobin Intestinal obstruction Intussusception Iron deficiency Malignancy Medical imaging Nutrient deficiency Pain Sarcoma Small intestine Vomiting Weight loss Young adults |
Title | Extraskeletal Ewing sarcoma of the duodenum presenting as duodenojejunal intussusception |
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