Case Report

Ewing's Sarcoma as Second Malignant Neoplasm after Retinoblastoma: A Case Report
Rakesh Mittal^a, Shafika Al Awadi^a, Omar Sahar^a, A.M. Behbehani<sup>b

a</sup>Department of Medical Oncology, Hussain Maki Al Juma Centre for Specialized Surgeries, and
^bAl Bahar Eye Centre, Kuwait

Address of Corresponding Author

Med Princ Pract 2008;17:84-85 (DOI: 10.1159/000109597)

  Key Words

• Retinoblastoma
• Second malignant neoplasm
• Ewing's sarcoma

  Abstract

Objectives: To report a case of a child with the hereditary form of unilateral retinoblastoma (RB), who developed Ewing's sarcoma of the right fibula 3 years after the enucleation of the right eye. Case Presentation and Intervention: The child was diagnosed as a case of RB of the right eye at the age of 9 months. He was fully investigated and found to have locally advanced RB with bone marrow involvement (Reese-Ellsworth stage IVA). Enucleation was recommended to the family, but they refused. The patient received chemotherapy and diode laser thermotherapy in Kuwait and the UK. He had a local relapse after 11 months and subsequently underwent enucleation of the right eye. After 3 years, he was investigated for a small swelling in his right lower leg. After extensive investigations, it was reported as Ewing's sarcoma. He was treated with chemotherapy, surgery (complete excision of the fibula) and high-dose chemotherapy followed by autologous stem cell transplantation. The child is now nearly 2 years after completing the treatment and is disease free. Conclusions: This case confirms the increased risk of a second malignant neoplasm (SMN) in children with hereditary RB. These children need a very close follow-up for the early diagnosis of SMNs or even subsequent malignancies.

Copyright © 2007 S. Karger AG, Basel

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  Author Contacts

Dr. Rakesh Mittal
Department of Medical Oncology
Hussain Maki Al Juma Centre for Specialized Surgeries
PO Box 42262, Shuwaikh 70653 (Kuwait)
Tel. +965 483 8252, Fax +965 481 0007, E-Mail rakeshmittal55@hotmail.com

  Article Information

Received: February 17, 2007
Revised: May 1, 2007
Number of Print Pages : 2
Number of Figures : 0, Number of Tables : 0, Number of References : 12

  Publication Details

Medical Principles and Practice (International Journal of the Kuwait University Health Sciences Centre)

Vol. 17, No. 1, Year 2008 (Cover Date: December 2007)

Journal Editor: Owunwanne, A. (Kuwait)
ISSN: 1011-7571 (print), 1423-0151 (Online)

For additional information: http://www.karger.com/MPP

  Drug Dosage / Copyright

Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.