The following is a summary of “Extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumour of the kidney: a case report and literature review” published in the November 2022 issue of Urology by Li et al.

Extraosseous Ewing’s sarcoma/peripheral primitive neuroectodermal tumors (EWS/pPNETs) of the kidney are uncommon. The signs and symptoms of EWS are not like those of other diseases. Symptoms include blood in the urine, pain in the abdomen, or a mass that can be felt. A thorough look at the research shows that more than a physical exam is needed to diagnose correctly. The results of imaging EWS/pPNETs are not very clear. Researchers used contrast-enhanced ultrasound (CEUS) to find out that the patient had an EWS/pPNET, which they had never heard of before.

This article is about a 20-year-old woman who had a mass in her abdomen and a lot of blood in her urine for a month. The ultrasound showed a mass in the lower part of the left kidney that was not echoing and had a clear edge. The CEUS showed signs of annular enhancement and heterogeneous enhancement on the tumor, and simultaneous wash-in was the most common. The images from the CT scan showed a low-density, elliptical tumor. The patient’s left kidney was taken out, and a pathologist found that the patient had an EWS/pPNET. The patient had 8 cycles of CAV (vinorelbine, ifosfamide, epirubicin) + IE (isocyclophosphamide, etoposide) chemotherapy 21 days after the kidney surgery. After surgery, the tumor bed was used as the radiation field for nearly 30 days of radiotherapy (dose: 45 Gy, radiation field: the tumor bed). In a 4-year follow-up, there were no signs of cancer coming back locally or spreading to other parts of the body.

Ultrasound was the most popular way to check on the kidneys because it didn’t use radiation, was cheap and easy to use and could be done over and over again. Early CEUS helped doctors figure out what was wrong. Then, surgery and additional radiation or chemotherapy is given at the right time can stop the disease from getting worse.