Extraskeletal Ewing Sarcoma | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Extraskeletal Ewing Sarcoma

Axial T2-weighted MRI (image 1) and coronal T1-weighted postcontrast MRI (image 2) performed in a child show a solid, non-enhancing mass (arrow) arising within the midportion of the left kidney. The most common renal malignancy in a child is Wilms tumor followed by renal cell carcinoma. In this instance, the tumor was confirmed to represent a soft tissue Ewing sarcoma. Extra-skeletal Ewing's sarcoma most commonly arises from the paravertebral spaces, lower extremities, head and neck region, or the pelvis. Renal Ewing sarcoma is incredibly rare.

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Coronal (image 1) and axial (image 2) T2-weighted images show a large solid mass (arrows) within the mid right kidney. A rim of renal parenchyma (arrowheads) is seen both at the superior and inferior aspect of the tumor. Wilms tumor is by far the most common renal malignancy of childhood. This patient was diagnosed with a clear cell sarcoma, a rare renal tumor. Clear cell sarcoma account for 4% of all pediatric renal tumors. They occur most commonly between 3-5 years of age and are 2 times more common in males.