Ewing's Sarcoma at the occipital bone presenting as acute epidural hematoma:a case report Yoji YAMASHITA 1,2 , Toshihiro KUMABE 2 , Tomoko KOBAYASHI 1,2 , Hisashi ABIKO 1 , Hirofumi SEKI 3 , Takashi YOSHIMOTO 2 1Department of Neurosurgery, Ohara Medical Center Hospital 2Department of Neurosurgery, Tohoku University School of Medicine 3Department of Neurosurgery, Iwate Prefectural Central Hospital Keyword: acute epidural hematoma , Ewing's sarcoma , occipital bone pp.567-571
Published Date 1997/6/10
DOI https://doi.org/10.11477/mf.1436901409
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Primary cranial Ewing's sarcoma is rare. We describe an exceptionally rare case of primary Ewing's sarcoma of the occipital bone, presenting as spontaneous acute epidural hematoma.

A 19-year-old female was admitted to our hospital complaining of sudden onset of severe headache. There were no neurological deficit and no abnormal labora-tory findings. Computerized tomographic (CT) scan re-vealed a lentiform shaped high density lesion at the left occipital epidural space. Magnetic resonance imaging (MRI) showed the lesion as iso to low intensity on T1-weighted image (T1WI) and mixed signal intensity on T2-weighted image (T2WI). There were no pathologi-cal findings at the adjacent brain. Cerebral angiography demonstrated mass effect. Right occipital craniotomy was performed. We found the tumor arising from the occipital bone and located at the epidural space. The tumor was resected totally. Histological examination re-vealed the tumor as Ewing's sarcoma with intratumoral hemorrhage. The postoperative course was uneventful. Radiation therapy (50Gy) was given. Follow-up ex-amination six years after the treatment found no evi-dence of tumor recurrence or distant metastasis. It should be born in mind that primary Ewing's sar-coma of the skull can cause spontaneous acute epidural hematoma.

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