Athary Saleem,Hadeel Al Muzayen,Mohammed Alshamali,Emad Fahim,Sami Aldaoud,Nawaf AlKhalifah,Khaleel Mohammad,
Rectal Ewing’s Sarcoma: A Case Report of An Unusual Extra-Skeletal Tumor Presentation
American Journal of Oncological Surgery
2023

http://dx.doi.org/10.31487/j.AJOS.2023.01.01
https://www.sciencerepository.org/rectal-ewings-sarcoma_AJOS-2023-1-101 
Abstract: Introduction: Extraskeletal Ewing’s sarcoma (EES) is a rare malignant soft tissue tumor. Those aggressive mesenchymal tumors are characterized by genetic alterations of the Ewing sarcoma gene (EWS) on chromosome 22. Signs and symptoms are usually non-specific. The clinical diagnosis of EES is challenging.
Case Presentation: A 31-year-old female patient presented to our hospital with rectal bleeding. Physical examination revealed a painful and erythematous bleeding rectal mass. A pelvic MRI revealed a right-sided well-circumscribed perianal mass measuring 6.8 × 6.0 cm. Surgical excision of the rectal mass was subsequently performed. The resected specimen, including the rectal mass with a pedicle from the posterior rectal wall was sent for histopathological examination. The postoperative period was uneventful. Histopathology examination was suggestive of EES of the rectum.
Clinical Discussion: EES is an unusual entity of Ewing's Sarcoma Family of Tumors, which are characterized by pathognomonic translocations. The clinical features of EES include localized pain and/or swelling. Diagnosis of EES relies on histopathology and immunohistochemistry analysis. Imaging modalities such as CT, MRI, and PET/CT are crucial to evaluate EES metastasis and assess local tumor resectability. 
Conclusion: Due to the rare entity of EES of the rectum, we report the case of a 31-year-old female with rectal bleeding, found to be rectal Ewing’s sarcoma.Keywords: Case report, ewing sarcoma family of tumors, extra-skeletal, rectal bleeding, surgery