Cutaneous Ewing's sarcoma secondary to chemotherapy given for testis tumor: Case report

INTRODUCTION: Testicular cancer has high cure rates, especially after the adjuvant use of chemotherapy. Secondary tumors may develop months and years after the primary tumor. We aimed to report a case of cutaneous Ewing's sarcoma at the site of surgery 3 years after BEP chemotherapy. PRESENTATION OF CASE: 21 year old male underwent radical orchiectomy in 2008. After one year surgical site complaints brought him to same hospital. A limited surgical resection was made. As his complaints continued he applied to our clinic. We resected the lesion with a 5 cm safety margin with the light of previous medical history. Pathology revealed cutaneous Ewing's sarcoma, and patient received VACD-IE chemotherapy. He is free of recurrence till now. DISCUSSION: Chemotherapy may cause secondary cancer especially in long term. In this case secondary tumor is diagnosed three years after surgery. Patient underwent therapeutic surgery and received chemotherapy (VACD-IE) for secondary Ewing's sarcoma. Early diagnosis and definitive treatment provide recurrence free survival in the patient. CONCLUSION: Secondary tumors can emerge months or years after primary tumor therapies, and are not related with the primary tumors. Any lesion or sign should be investigated carefully. Early diagnosis and correct treatment could prevent dramatic results.