J Korean Med Sci.  2005 Aug;20(4):687-690. 10.3346/jkms.2005.20.4.687.

Extraskeletal Ewing's Sarcoma of the Hard Palate

• Kang MS
• Yoon HK
• Choi JB
• Eum JW

• KMID: 1712757
• DOI: http://doi.org/10.3346/jkms.2005.20.4.687

Abstract

Extraskeletal Ewing's sarcoma (EES) is a rare soft tissue tumor morphologically indistinguishable from the more common Ewing's sarcoma of bone. We report a case of EES arising in the hard palate of 34-yr-old male patient. Microscopically, the monotonous small round cells without neuronal differentiation showed membranous positive immunoreactivity for MIC2/CD99 and vimentin. Ultrastructurally, the tumor cells showed a few intracytoplasmic organelles without evidence of neurosecretory granules or neurofilaments. The EWS-FLI1 chimeric gene was identified using the nested reverse transcriptase-polymerase chain reaction.

Keyword

Sarcoma; Ewing's; Palate, Hard

MeSH Terms

Adult
Antigens, CD/analysis
Cell Adhesion Molecules/analysis
Humans
Immunohistochemistry
Male
Oncogene Proteins, Fusion/genetics
Palatal Neoplasms/genetics/metabolism/*pathology
Palate, Hard/metabolism/*pathology
Proto-Oncogene Protein c-fli-1/genetics
Reverse Transcriptase Polymerase Chain Reaction
Sarcoma, Ewing's/genetics/metabolism/*pathology
Transcription, Genetic
Vimentin/analysis

Figure

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  Fig. 1 A nodular submucosal tumor is noted on the left side of hard palate.

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  Fig. 2 The paranasal CT scan showing a contrast-enhancing mass lesion in left side hard palate with focal bony destruction (*).

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  Fig. 3 Light microscopy of the tumor shows closely packed small round cells with abundant thin-walled vessels (H&E, ×40).

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  Fig. 4 Acini of minor salivary gland are seen at the periphery of tumor (arrow) (H&E, ×10).

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  Fig. 5 Most of the tumor cells have scanty cytoplasm and round or oval nuclei with fine powdery chromatin (H&E, ×400).

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  Fig. 6 Strong membranous MIC2/CD99 immunoreactivity (LSAB, ×200).

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  Fig. 7 EWS/FLI1 chimeric gene of approximately 260 bp is identified by RT-PCR in this case (arrow) (M, size marker; lane 1, positive control; lane 2, negative control; lane 3, this case).

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