{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:35:56Z","timestamp":1788942956975,"version":"build-2803163510"},"reference-count":13,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,12]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>We present a case of a 34-year-old woman who presented with complaints of fever, cough and dyspnoea of 2 months\u2019 duration. On evaluation, she was diagnosed with a rare entity primary pleural Ewing\u2019s sarcoma with synchronous metastases to mediastinal, supraclavicular nodes and single vertebra. Due to the rarity of this entity and lack of treatment guidelines on extraosseous Ewing\u2019s sarcoma, the patient was managed with a combination of multiagent chemotherapy, surgery and radiotherapy as per standard guidelines for skeletal Ewing\u2019s sarcoma. We present this case to discuss differential diagnoses and management dilemmas encountered on the use of local modalities such as surgery and radiotherapy for control of primary and metastatic sites.<\/jats:p>","DOI":"10.1136\/bcr-2021-243495","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T12:13:47Z","timestamp":1624277627000},"page":"e243495","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Dilemma in diagnosis and management of rare primary pleural Ewing\u2019s sarcoma with synchronous limited metastatic disease"],"prefix":"10.1136","volume":"14","author":[{"given":"Abhijith","family":"Bhaskaran","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0663-6424","authenticated-orcid":false,"given":"Pooja","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pampa Ch","family":"Toi","sequence":"additional","affiliation":[{"name":"Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education, Puducherry, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2189-5056","authenticated-orcid":false,"given":"Prasanth","family":"Penumadu","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"2025082700540922000_14.6.e243495.1","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1053\/j.sult.2011.05.002","article-title":"Imaging of thoracic sarcomas of the chest wall, pleura, and lung","volume":"32","author":"Foran","year":"2011","journal-title":"Semin Ultrasound CT MR"},{"key":"2025082700540922000_14.6.e243495.2","doi-asserted-by":"crossref","first-page":"71","DOI":"10.4103\/jco.jco_7_19","article-title":"Primary pleural primitive neuroectodermal tumor: incidental diagnosis of a rare pathology","volume":"2","author":"Eshpuniyani","year":"2019","journal-title":"J Curr Oncol"},{"key":"2025082700540922000_14.6.e243495.3","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1093\/icvts\/ivr023","article-title":"Rapidly growing intrathoracic extraskeletal Ewing's sarcoma","volume":"14","author":"Tsunezuka","year":"2012","journal-title":"Interact Cardiovasc Thorac Surg"},{"key":"2025082700540922000_14.6.e243495.4","first-page":"363","article-title":"A case of extraskeletal Ewing sarcoma originating from the visceral pleura","volume":"15","author":"Karatziou","year":"2011","journal-title":"Hippokratia"},{"key":"2025082700540922000_14.6.e243495.5","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197906)43:6<2438::AID-CNCR2820430640>3.0.CO;2-9"},{"key":"2025082700540922000_14.6.e243495.6","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197507)36:1<240::AID-CNCR2820360127>3.0.CO;2-H"},{"key":"2025082700540922000_14.6.e243495.7","doi-asserted-by":"publisher","DOI":"10.1148\/rg.333135005"},{"key":"2025082700540922000_14.6.e243495.8","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1007\/s00428-014-1627-1","article-title":"The combination of CD99 and Nkx2.2, a transcriptional target of EWSR1-FLI1, is highly specific for the diagnosis of Ewing sarcoma","volume":"465","author":"Shibuya","year":"2014","journal-title":"Virchows Arch"},{"key":"2025082700540922000_14.6.e243495.9","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.11.6667"},{"key":"2025082700540922000_14.6.e243495.10","unstructured":"Clinical sarcoma research. 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