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PubMed2005

Imaging characteristics of primary cranial Ewing sarcoma.

BACKGROUND: Ewing sarcoma accounts for 10-15% of all childhood malignant bone tumours and is second in prevalence to osteosarcoma. The skull bones are an unusual site of origin of primary Ewing sarcoma in children. Previous reports concentrate on the neurosurgical aspects and relatively good outcome compared to other bone tumours of the calvarium. Reported cases mainly describe the imaging characteristics on CT. OBJECTIVE: To describe the MRI and CT features of primary cranial Ewing sarcoma. MATERIALS AND METHODS: The neuroimaging of three cases of primary cranial Ewing sarcoma are reviewed. RESULTS: Our three cases show an extra-axial mass that is high attenuation on CT and low signal on T2-weighted MRI. Haemorrhagic components, dural extension and contrast enhancement are also characteristic features. CONCLUSION: CT attenuation and magnetic resonance signal characteristics reflect sheets of densely packed cells seen in Ewing sarcoma.

Child↗
PubMed1996

Mobilization of tumour cells during biopsy in an infant with Ewing sarcoma.

UNLABELLED: Ewing sarcoma and the closely related peripheral primitive neuroectodermal tumour, recently referred to as Ewing tumour (ET), are characterised by unique gene rearrangements on chromosome 22. The breakpoints have been cloned and shown to fuse the Ewing sarcoma gene to one of two closely related ETS proto-oncogens, FLI-1 or ERG, which reside on chromosomes 11 and 21, respectively. The rearrangement results in the expression of specific hybrid transcripts which can be detected with high sensitivity by the reverse transcriptase polymerase chain reaction technique (RT-PCR) in primary tumours, blood and bone marrow. We report on a 7-month-old boy with a pelvic Ewing sarcoma in whom circulating tumour cells were identified in the peripheral blood during open tumour biopsy by RT-PCR. However, before and 6 days after surgery no tumour cells could be detected in the peripheral blood. CONCLUSION: The application of RT-PCR to monitor shedding of tumour cells during surgical intervention will help to evaluate if open biopsy potentially contributes to metastatic tumour cell spread.

Base Sequence↗
PubMed2026

Integrated Immunotherapy Target Atlas for Ewing Sarcoma.

BACKGROUND/AIM: Ewing sarcoma is a fusion-driven malignancy with low tumor mutational burden, making recurrent tumor-associated antigens with favorable tumor-to-normal contrast central to immunotherapy development. We converted the Deng et al.-defined 32-gene Ewing Sarcoma Specific Signature (ESS32) into a practical target atlas by integrating tumor RNA expression with normal-tissue context, protein evidence, subcellular localization, and therapeutic accessibility. MATERIALS AND METHODS: A 38-gene set was analyzed, including ESS32 and six comparator antigens (STEAP1, LINGO1, PRAME, CD99, CD276/B7-H3, and ENPP1). Eight Gene Expression Omnibus datasets (n=854 samples) were assigned predefined roles spanning tumor-versus-skeletal-muscle comparison, broad normal-organ context, EWSR1::FLI1 perturbation, tumor-only support cohorts, cell-line models, and cross-sarcoma comparison. Results were overlaid with Human Protein Atlas and published proteomic/surfaceome evidence. RESULTS: In GSE17674, the strongest tumor-enriched transcripts included NKX2-2, NPY1R, STEAP1, RBM11, RNF182, LIPI, CD99, STEAP2, LOXHD1, and DCDC2. Normal-tissue and compartment data substantially reordered RNA-only ranking. NKX2-2 showed the strongest Ewing-associated signal but encodes a nuclear transcription factor, favoring peptide-HLA/T-cell receptor (TCR) or vaccine development. RBM11 and LIPI emerged as high-interest intracellular/secretome-associated candidates, with an explicit epididymal/male reproductive caveat for LIPI. CD99 and NPY1R illustrated normal-cell reservoir and receptor-distribution constraints. CONCLUSION: ESS32 should be interpreted as an EWSR1::FLI1-associated RNA discovery set, not as a pre-validated target panel. Practical nomination requires integration of RNA enrichment, normal-tissue distribution, protein evidence, cellular compartment, and modality compatibility before nomination of TCR, vaccine, antibody-drug conjugate (ADC), chimeric antigen receptor (CAR), radioligand, or validation-first candidates.

Humans↗
PubMed2006

Clinically tolerable concentrations of arsenic trioxide induce p53-independent cell death and repress NF-kappa B activation in Ewing sarcoma cells.

Ewing sarcoma (ES), a highly malignant pediatric tumor, is consistently associated with translocations that fuse the EWS gene with a member of the ETS family gene, most commonly FLI-1. Despite significant advances with multiagent chemotherapy, surgery and radiotherapy, about 40% of ES patients still die from the disease. It is therefore necessary to explore novel agents for possible treatment of this tumor. Here the authors investigated the sensitivity of ES cells to clinically tolerable concentrations of arsenic trioxide (As2O3), a compound known to induce differentiation and apoptosis of other types of malignant cells. The authors report that As2O3 uniformly induced death of 6 ES-derived cell lines irrespective of their p53 status. As2O3 resulted in an apoptotic phenotype which was inhibited by the broad-spectrum caspase inhibitor ZVAD-fmk. These effects correlated with prolonged c-jun N-terminal kinase activation, which is a signal for apoptosis in ES cells. As2O3 also decreased basal and cytokine-induced NF-kappa B activity. Since the authors previously demonstrated that NF-kappa B exerts an antiapoptotic action in ES cells, As2O3 treatment may also result in a sensitization of these cells to other drugs used in combination therapy. These effects, combined with its antiangiogenic action, define As2O3 as a good candidate for future protocols to improve treatments of Ewing sarcomas, irrespective of the p53 status of the tumor.

Apoptosis↗
PubMed2026

EWS-RNA Binding Protein 1: Structural Insights into Ewing Sarcoma by Conformational Dynamics Investigations.

BACKGROUND: Prior research has demonstrated that proteins play a significant role in the prognosis and treatments of various sarcomas, including Ewing sarcoma through the interplay of downstream signaling cascades. However, there is limited understanding about the strcucture conformation of EWSR1 and its structural implication in the prognosis of Ewsing Sarcoma by interaction with RNA molecules. AIMS: The primary goal of ongoing research is to determine how EWSR1 contributes to Ewing sarcoma. OBJECTIVE: The current study explores the complexity of EWSR1 structure and its conformational interactions with RNA in relation to Ewing sarcoma. METHODS: Here, we employed a comparative modeling approach to predict EWSR1 domains separately and assembled them into one structural unit using a DEMO server. Additionally, the RNA motifs interacting with EWSR1 were predicted, and the 3D model was built using RNAComposer. Protein-RNA docking and MD simulation studies were carried out to check the intermolecular interactions and stability behavior of docked EWSR1-RNA complexes. RESULTS: The overall results explore the structural insights into EWSR1 and their interactions with RNA, which may play a momentous role in co- and post-transcriptional regulation to control gene expression. CONCLUSION: Taken togather, our findings suggest that EWSR1 may be a useful therapeutic target for the diagnosis and management of Ewing sarcoma.

Sarcoma, Ewing↗
PubMed2007

A single institution experience of combined modality management of extra skeletal Ewings sarcoma.

BACKGROUND: Extraskeletal Ewings sarcoma are rare tumors for which there is no consensus on optimal management. METHODS: A retrospective review of the clinical features, treatment and outcome of patients with extraskeletal Ewings sarcoma who reported to a single institution between January 1992-December 2003 is reported. RESULTS: A total of 19 patients with extraskeletal Ewings sarcoma were identified. Of these, 4 patients had metastatic disease at presentation and 15 patients with non-metastatic disease received combined modality treatment with primary combination chemotherapy followed by local treatment with radiotherapy or surgery. Disease free survival and overall survival for patients with non metastatic disease after combined modality treatment were 60% and 30% respectively. The significant predictors for prolonged disease free survival and overall survival were high haemoglobin (p = 0.002), low lactate dehydrogenase (p = 0.028), chemotherapy with Vincristine, Adriamycin, Cyclophosphamide, Ifosfamide and Etoposide regime (p = 0.008) and complete response to chemotherapy (p = 0.001). CONCLUSION: Aggressive combination chemotherapy followed by complete surgery or radiotherapy to a dose of more than 50 Gy is essential to confer optimal outcome for patients with extraskeletal Ewings sarcoma.

Adolescent↗
PubMed1994

[Cytodiagnosis of Ewing sarcoma].

Pelvic Ewing's sarcomas were studied by fine needle aspiration biopsy in two young male patients. Local pain, subfebrility, high ESR had occurred in both cases. X ray examination showed osteolytic lesions in both patients. The differential diagnostic question was, are the lesions osteomyelitis or malignant tumors? Fine needle aspiration biopsies and cytological examinations were performed in order to determine the nature of the lesions. The aspirates consisted of monotonous population of small undifferentiated tumor cells. The nuclei were monomorph with small nucleoli and finely granular chromatin. The tumor cells contained large amounts of PAS positive diastase-digestible granular cytoplasmic glycogen. The aspirated material was examined by immunocytochemistry and electronmicroscopy in one of the cases. Both of these methods had diagnostic value in our patients in the detection of Ewing's sarcoma.

Adolescent↗
PubMed1990

Primary Ewing sarcoma of rib.

Ewing sarcoma is a relatively common, highly malignant bone tumor that typically occurs in adolescents and young adults aged 10-25 years. Our archives contain 328 cases of histologically proved and radiologically correlated Ewing sarcoma collected in consultation over 40 years. From this series, we identified 34 lesions (10%) arising in ribs. Radiographically, the affected rib was predominantly lytic in most (82%) cases, but mixed lytic-sclerotic (9%) and even predominantly sclerotic (9%) patterns were also encountered. The affected rib was "expanded" in 35% of cases, although the contour change was usually mild. Abnormalities of the affected ipsilateral hemithorax varied from subtle, isolated rib involvement to solitary rib involvement accompanied by complete opacification of the hemithorax. We describe the spectrum of radiologic findings of primary Ewing sarcoma of rib, augmented where appropriate by accompanying pathologic material.

Adolescent↗
PubMed2002

Inhibition of constitutive NF-kappa B activity suppresses tumorigenicity of Ewing sarcoma EW7 cells.

Ewing sarcoma is 1 of the most aggressive tumors that can affect children and young adults. Despite advances in therapy, the prognosis remains poor emphasizing the need for defining new targets for treatment. We investigated a possible role of nuclear factor-kappa B (NF-kappa B) activity of Ewing sarcoma-derived EW7 cells in their tumorigenicity. In these cells, expression of a degradation-resistant form of the inhibitory factor I kappa B alpha inhibited NF-kappa B activity without affecting their in vitro proliferation rate. It causes, however, a remarkable loss of their ability to generate tumors in nude mice that correlates with both a decrease in extracellular matrix (ECM) protein secretion and an acquisition of sensitivity to murine tumor necrosis factor alpha (TNF alpha)-induced apoptosis. These data support the concept that NF-kappa B activity plays a role in the tumorigenicity of Ewing sarcoma cells, identifying NF-kappa B as a potential target for reducing Ewing tumor progression.

Angiogenesis Inducing Agents↗
PubMed2004

Wnt/Frizzled signaling in Ewing sarcoma.

BACKGROUND: The Ewing sarcoma family of tumors (ESFT) is a set of neuroectodermal malignancies that typically presents in the second decade and has a poor prognosis due to metastatic disease. Wnt signaling has a critical role in the normal development of multiple neuroectodermal tissues and also contributes to the neoplastic properties of tumor cells of neuroectodermal origin. PROCEDURE: We surveyed the expression of Wnts and their receptors in nine ESFT cell lines by RT-PCR analysis. We also tested biological response of ESFT cell lines to exogenous Wnts in beta-catenin stabilization, actin stress fiber formation, and chemotaxis assays. RESULTS: We detected Wnt-10b in all the lines, and most also expressed Wnt-5a, Wnt-11, and Wnt-13. Several Frizzleds (Fz) and the Wnt co-receptors, low density lipoprotein-receptor-like proteins 5 and 6 were also expressed. We observed a marked stimulation of the beta-catenin/canonical Wnt pathway in ESFT cells treated with Wnt-3a. Wnt-3a induced morphologic changes characterized by the formation of long cytoplasmic extensions in ESFT cells. We also observed chemotaxis of ESFT cells in response to Wnt-3a. CONCLUSIONS: These results provide evidence that components of Wnt/Fz pathway are expressed and an intact Wnt/Frizzled signaling pathway exists in ESFT cell lines. Activation of the Wnt pathway in ESFT suggests that Wnt modulates cell motility rather than cell proliferation. Hence, activation of this pathway may influence metastatic potential of ESFT.

Cell Line, Tumor↗
PubMed1999

The cytology of extraskeletal Ewing sarcoma.

BACKGROUND: Extraskeletal Ewing sarcoma (EES) shares histologic, immunohistochemical, and molecular findings with ES of bone. The authors' goal in conducting this study was to examine the cytomorphologic features of EES. In addition, immunocytostaining for CD99/O13 was performed in all cases, and cytogenetic and molecular data were available in about half of the cases. METHODS: The authors studied 20 aspiration cases, all with histopathologic confirmation, and also conducted immunohistochemistry and/or molecular studies. RESULTS: All cases had cellular smears with many single cells and focal clustering. Numerous naked nuclei and focal crush artifacts were seen. Mitosis and necrosis were rare. Four cases had cytoplasmic vacuoles. Five cases showed nuclear molding. Seventeen cases (85%) exhibited small cells with scanty cytoplasm and nuclei with fine chromatin and small nucleoli, representing the so-called typical variant. One case (5%) revealed cells with abundant cytoplasm, large nuclei, and large eosinophilic nucleoli, an example of the atypical or large cell variant. Two cases (10%) had features in between, with cells showing a fair amount of cytoplasm and medium-sized nucleoli, representing the intermediate variant. Nuclear grooves, described as common in the latter, were rare. In all cases, in either cytologic or corresponding histologic material, CD99/O13 immunocytostaining showed strong membranous reactivity. In addition, cytogenetic and/or molecular evidence of ES specific chromosomal translocation was demonstrated in histologic or cytologic material in 10 cases. CONCLUSIONS: EES shows cytologic features similar to ES of bone, with a spectrum of changes ranging from the typical appearance in a majority of cases to intermediate and atypical variants in a minority of cases. CD99/O13 immunocytostaining and/or molecular studies, particularly in the intermediate and atypical variants, may help in establishing a definitive fine-needle aspiration diagnosis, thus avoiding an open surgical biopsy.

12E7 Antigen↗
PubMed2000

Biphenotypic sarcoma with characteristics of both a Ewing sarcoma and a desmoplastic small round cell tumor.

BACKGROUND: The EWS gene, a transcription factor of unknown function, is involved in chromosomal translocations associated with a wide variety of tumors, particularly small round blue cell tumors such as Ewing sarcoma. It has previously been reported that desmoplastic small round blue cell tumor (DSRBCT) frequently has an associated t(11;22) abnormality resulting from fusion of the EWS and WT-1 genes. PROCEDURE: We report a case of a small round blue cell tumor with characteristics of both Ewing sarcoma and DSRBCT with a t(11;22) translocation leading to fusion of the EWS and FLI1genes. RESULTS: The translocation point and fusion products were confirmed by polymerase chain reaction amplification and restriction fragment mapping of the products. CONCLUSIONS: The biphenotypic nature of this case and the apparent promiscuity of the EWS gene in tumor-associated translocations coupled with other reports of biphenotypic childhood sarcomas has potential implications for the relationship between small round blue cell tumors and the mechanism of EWS/FLI1 oncogenesis.

Carcinoma, Small Cell↗
PubMed2000

Extraosseous Ewing sarcoma of the vagina.

BACKGROUND: Ewing sarcoma is a highly malignant childhood bone neoplasm. Extraosseous presentations of Ewing sarcomas include the trunk, extremities, uterus, cervix, and vagina. CASE: A 35-year-old woman, gravida 3, para 3, presented with a painless vaginal mass. After surgical excision, pathology results diagnosed an extraosseous Ewing sarcoma. Chemotherapy was given, followed by external beam and vaginal intracavitary brachytherapy, then more chemotherapy. After 48 months post-treatment, there is no clinical evidence of recurrence. CONCLUSION: Although rare, Ewing sarcoma can present as a vaginal mass.

Adult↗
PubMed2006

Molecular cytogenetic characterization of four previously established and two newly established Ewing sarcoma cell lines.

Most Ewing family tumors are identified by the characteristic translocation t(11;22)(q24;q12), resulting in a fusion protein EWS/FLI1 that acts as an aberrant transcription factor. In a minority of cases, the EWS gene is fused to another member of the ETS gene (ERG, ETV1, E1AF, and FEV). Though the oncogenic transforming capability of the EWS/FLI1 protein is highly suggestive, the exact pathway behind remains to be elucidated. The availability of cell lines may help in the understanding of underlying cellular processes. In this study, we have established two new Ewing sarcoma cell lines and characterized them with molecular cytogenetic tools. This technology was also applied on four other previously published Ewing sarcoma cell lines. Our findings in relation to previous data on similar tumors are discussed.

Adolescent↗
PubMed1983

Extraskeletal Ewings sarcoma.

A case of Ewings sarcoma arising in the soft tissue of the thumb is described. This appears to be the first case of digital extraskeletal Ewings sarcoma. The soft tissue location, the primary rather than metastatic nature, and the tumor type in this case were well documented.

Adenocarcinoma↗
PubMed1998

[Ewing sarcoma. Diagnostic imaging].

Ewing's sarcoma is a highly malignant neoplasm of the bone whose origin is still uncertain. A strong relationship exists between Ewing's sarcoma and tumors of neural origin (Ewing family of tumors). Ewing's sarcoma must be distinguished from other round-cell tumors like lymphoma and neuroblastoma and also must be differentiated from osteogenic sarcomas. On plain radiographs, Ewing's sarcoma appears as a lytic or mixed lytic-sclerotic, rarely as predominantly sclerotic lesion with margins Lodwick grade III. It is located primarily in the diaphyseal and metadiaphyseal regions of the long bones of the lower extremities. A large soft tissue tumor is usually present. Magnetic resonance imaging is the imaging modality of choice to evaluate the extent of the primary lesion, to monitor the response to neoadjuvant chemotherapy and to follow up non-resected Ewing's sarcomas. Bone scintigraphy is necessary to detect skeletal metastasis, and 201thallium scanning has been shown to be sensitive in the monitoring of treatment response. Today, computed tomography is not longer used to image the tumor site; however, spiral CT of the lungs plays a central role as a staging and follow-up tool.

Bone Neoplasms↗
PubMed2006

Impact of whole-body MRI and FDG-PET on staging and assessment of therapy response in a patient with Ewing sarcoma.

In patients with Ewing sarcoma, precise staging is not only crucial for the therapeutic regimen but also for a reliable evaluation of response to therapy. We report on a 15-year-old girl with metastatic spread of a Ewing sarcoma who, apart from conventional staging by bone scan, chest X-ray and CT, was subsidiary examined by FDG-PET and whole-body MRI before and after chemotherapy. Both modalities detected more bone lesions than the bone scan, which led to an altered strategy for radiotherapy. Both examinations might be a great asset to stage-adjusted therapy regimens, ultimately influencing patient outcome.

Adolescent↗