Acta Orthop. 2005 Dec;76(6):899-903.
Long-term follow-up of 15 patients with non-metastatic Ewing's
sarcoma and a skip lesion.
Jiya TU, Wuisman PI
Department of Orthopaedic Surgery, Vrije Universiteit Medical Centre,
BACKGROUND Skip lesions in Ewing's sarcoma of the bone seem to be rare;
to our knowledge only 7 cases have been published in the English
medical literature. METHODS: We retrospectively reviewed imaging and
histological data relating to 235 patients with non-metastatic Ewing's
sarcoma of the bone who participated in the cooperative Ewing's sarcoma
study (CESS 86 and CESS 91), and we identified 15 patients with a skip
lesion at diagnosis. RESULTS: The skip lesion was located in the same
bone as the primary tumor in 13 patients, and in an adjacent
juxtaarticular bone in 2 cases. The average follow-up was 11 years.
Despite aggressive treatment including surgery in all cases, tumor
relapse occurred in 9 patients, and 7 of these patients died due to
metastatic disease. INTERPRETATION: Skip lesions in patients with
otherwise non-metastatic skeletal Ewing's sarcoma may be of the same
consequence as the molecular detection of marrow metastases and
possibly confer a worse prognosis. Newer imaging modalities (for
example PET) and careful staging work-up may indicate that skip
metastases in Ewing's sarcoma are more common than previously suspected.
PMID: 16470449 [PubMed – indexed for MEDLINE]