Unusual presentation of Ewing sarcoma in the adrenal gland: a secondary malignancy from a survivor of Burkitt lymphoma

Jpn J Clin Oncol. 2013 Jun;43(6):676-80. doi: 10.1093/jjco/hyt047. Epub 2013 Apr 5.

Abstract

The occurrence of Ewing sarcoma as a secondary malignancy is an extremely rare event in long-term cancer survivors. In addition, the occurrence of Ewing sarcoma in the adrenal gland is highly unusual. In this case report, we treated a 20-year-old male patient with cyclophosphamide, doxorubicin, vincristine, dexamethasone, and methotrexate and cytarabine chemotherapy following a diagnosis of Stage IV Burkitt lymphoma. Following complete remission, he had been maintained for 2 years without evidence of disease. However, a regular follow-up computed tomography scan found a left adrenal gland mass and a biopsy revealed positive membrane-localized mic-2 expression (CD99) and the presence of the translocation of the EWSR1 gene. To our knowledge, this is the first case report of Ewing sarcoma occurring in the adrenal gland of a patient who was treated with cyclophosphamide, doxorubicin, vincristine, dexamethasone/methotrexate and cytarabine chemotherapy for Burkitt lymphoma.

Keywords: Burkitt lymphoma; Ewing sarcoma; secondary malignancy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adrenal Gland Neoplasms / pathology*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Burkitt Lymphoma / drug therapy*
  • Burkitt Lymphoma / pathology
  • Cyclophosphamide / administration & dosage
  • Cytarabine / administration & dosage
  • Doxorubicin / administration & dosage
  • Humans
  • Ifosfamide / therapeutic use
  • Male
  • Methotrexate / administration & dosage
  • Prednisone / administration & dosage
  • Remission Induction
  • Sarcoma, Ewing / pathology*
  • Young Adult

Substances

  • Cytarabine
  • Doxorubicin
  • Cyclophosphamide
  • Ifosfamide
  • Prednisone
  • Methotrexate