No identifiable primary, only metastases: Case report of a small round blue cell tumor consistent with Ewing sarcoma presenting with multisystem spread in a young woman

Authors

• Simra Irfan, Aga Khan UniversityFollow
• Ahmed Muneeb, Aga Khan University
• Mallick Muhammad Zohaib Uddin, Aga Khan UniversityFollow
• Muhammad Ahmed, Aga Khan University
• Abdullah Muhammad, Aga Khan University
• W. Memon, Aga Khan UniversityFollow

Document Type

Case Report

Department

Medical College Pakistan; Radiology

Abstract

Ewing sarcoma is the second most common malignant bone tumor in children and adolescents but remains rare and highly aggressive. We present the case of a 31-year-old woman with widespread metastatic disease suggestive of Ewing sarcoma, including lung, spinal, and brain involvement at presentation; however, no dominant primary lesion was identified despite extensive imaging. The patient’s clinical course was complicated by neuropathic pain, seizures, and severe treatment-related infections. She was managed with multi-agent chemotherapy and supportive care but ultimately left against medical advice due to socioeconomic constraints. This case illustrates the diagnostic and therapeutic challenges of Ewing sarcoma in low-resource settings and underscores the importance of early detection, molecular confirmation, and multidisciplinary management.

Comments

Pagination and issue are not provided by the author/publisher.

Publication (Name of Journal)

Clin Med Insights Case Rep

DOI

10.1177/11795476261457179

Recommended Citation

Irfan, S., Muneeb, A., Zohaib Uddin, M. M., Ahmed, M., Muhammad, A., Memon, W. (2026). No identifiable primary, only metastases: Case report of a small round blue cell tumor consistent with Ewing sarcoma presenting with multisystem spread in a young woman. Clin Med Insights Case Rep, 19.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_radiol/561