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Ewing Sarcoma Misdiagnosed as a Traumatic Hematoma: A Case from Family Practice

Patient: Female, 13-year-old Final Diagnosis: Ewing sarcoma Symptoms: Swelling Medication:— Clinical Procedure: — Specialty: Family Medicine OBJECTIVE: Mistake in diagnosis BACKGROUND: Timely diagnosis of cancers is crucial, as delays can adversely affect a patient’s outcome and experience. Since so...

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Autor principal: Shammari, Malak Al
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147899/
https://www.ncbi.nlm.nih.gov/pubmed/34021111
http://dx.doi.org/10.12659/AJCR.931843
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author Shammari, Malak Al
author_facet Shammari, Malak Al
author_sort Shammari, Malak Al
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description Patient: Female, 13-year-old Final Diagnosis: Ewing sarcoma Symptoms: Swelling Medication:— Clinical Procedure: — Specialty: Family Medicine OBJECTIVE: Mistake in diagnosis BACKGROUND: Timely diagnosis of cancers is crucial, as delays can adversely affect a patient’s outcome and experience. Since soft tissue hematoma is a common clinical condition following trauma, soft tissue tumors can be misdiagnosed as hematomas due to the similar clinical features. CASE REPORT: A 13-year-old girl presented with a gradually expanding swelling in the left arm that developed following minor trauma. She was seen by several general practitioners, and the swelling was managed as a soft tissue hematoma with the application of ice packs and compression, which did not result in any improvement. The initial plain radiograph of the left humerus revealed a large soft tissue swelling with areas of calcifications and minimal periosteal changes. The swelling was further evaluated by ultrasound, showing a hypoechoic lesion with internal septation and increased vascularity. These findings were mistakenly interpreted as a traumatic hematoma. Considering the prolonged duration and the progressive nature of the condition, the patient was referred for magnetic resonance imaging, which showed a soft tissue lesion involving the humeral shaft and sparing the proximal and distal epiphyses. An ultrasound-guided biopsy confirmed the diagnosis of Ewing sarcoma. CONCLUSIONS: Ewing sarcoma may present with a clinical picture similar to that of a traumatic hematoma. Hence, this case highlights the need for considering soft tissue tumors as a differential diagnosis in patients presenting with an expanding swelling. Primary care physicians should have a high index of suspicion for malignancies and should not be reluctant to refer patients for further investigations in cases exhibiting an unusual course of the clinical condition.
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spelling pubmed-81478992021-06-02 Ewing Sarcoma Misdiagnosed as a Traumatic Hematoma: A Case from Family Practice Shammari, Malak Al Am J Case Rep Articles Patient: Female, 13-year-old Final Diagnosis: Ewing sarcoma Symptoms: Swelling Medication:— Clinical Procedure: — Specialty: Family Medicine OBJECTIVE: Mistake in diagnosis BACKGROUND: Timely diagnosis of cancers is crucial, as delays can adversely affect a patient’s outcome and experience. Since soft tissue hematoma is a common clinical condition following trauma, soft tissue tumors can be misdiagnosed as hematomas due to the similar clinical features. CASE REPORT: A 13-year-old girl presented with a gradually expanding swelling in the left arm that developed following minor trauma. She was seen by several general practitioners, and the swelling was managed as a soft tissue hematoma with the application of ice packs and compression, which did not result in any improvement. The initial plain radiograph of the left humerus revealed a large soft tissue swelling with areas of calcifications and minimal periosteal changes. The swelling was further evaluated by ultrasound, showing a hypoechoic lesion with internal septation and increased vascularity. These findings were mistakenly interpreted as a traumatic hematoma. Considering the prolonged duration and the progressive nature of the condition, the patient was referred for magnetic resonance imaging, which showed a soft tissue lesion involving the humeral shaft and sparing the proximal and distal epiphyses. An ultrasound-guided biopsy confirmed the diagnosis of Ewing sarcoma. CONCLUSIONS: Ewing sarcoma may present with a clinical picture similar to that of a traumatic hematoma. Hence, this case highlights the need for considering soft tissue tumors as a differential diagnosis in patients presenting with an expanding swelling. Primary care physicians should have a high index of suspicion for malignancies and should not be reluctant to refer patients for further investigations in cases exhibiting an unusual course of the clinical condition. International Scientific Literature, Inc. 2021-05-22 /pmc/articles/PMC8147899/ /pubmed/34021111 http://dx.doi.org/10.12659/AJCR.931843 Text en © Am J Case Rep, 2021 https://creativecommons.org/licenses/by-nc-nd/4.0/This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Shammari, Malak Al
Ewing Sarcoma Misdiagnosed as a Traumatic Hematoma: A Case from Family Practice
title Ewing Sarcoma Misdiagnosed as a Traumatic Hematoma: A Case from Family Practice
title_full Ewing Sarcoma Misdiagnosed as a Traumatic Hematoma: A Case from Family Practice
title_fullStr Ewing Sarcoma Misdiagnosed as a Traumatic Hematoma: A Case from Family Practice
title_full_unstemmed Ewing Sarcoma Misdiagnosed as a Traumatic Hematoma: A Case from Family Practice
title_short Ewing Sarcoma Misdiagnosed as a Traumatic Hematoma: A Case from Family Practice
title_sort ewing sarcoma misdiagnosed as a traumatic hematoma: a case from family practice
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8147899/
https://www.ncbi.nlm.nih.gov/pubmed/34021111
http://dx.doi.org/10.12659/AJCR.931843
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