{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:05:21Z","timestamp":1756339521249,"version":"3.44.0"},"reference-count":14,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2024,11,11]]},"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:p>A female patient in her late teens presented with an initially episodic right-sided chest pain that gradually became persistent and associated with a high-grade fever, starting 15 days earlier but worsening over a week. Physical examination revealed tenderness on the right side of the chest and reduced air entry in the right middle and lower lung fields. Initial imaging demonstrated a right-sided pleural effusion with a chest wall mass lesion. A chronic infection like tuberculosis (TB) was suspected. However, an ultrasound-guided thoracentesis confirmed an exudative pleural effusion with low adenosine deaminase. Further, fine needle aspiration cytology of the mass revealed atypical small round cells with scanty cytoplasm and an immunohistochemistry profile consistent with Ewing\u2019s sarcoma. This case highlights the diagnostic challenges accompanying an unusual presentation of Ewing\u2019s sarcoma in the TB endemic region, which typically affects long bones but, in this instance, is manifested with pleural involvement and symptoms.<\/jats:p>","DOI":"10.1136\/bcr-2024-263039","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T21:45:51Z","timestamp":1733435151000},"page":"e263039","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Rare presentation of Ewing\u2019s sarcoma underscores the diagnostic challenges in atypical cases"],"prefix":"10.1136","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3909-5479","authenticated-orcid":false,"given":"Azmat","family":"Karim","sequence":"first","affiliation":[{"name":"Respiratory Medicine, Jawaharlal Nehru Medical College and Hospital, Aligarh, Uttar Pradesh, India"},{"name":"Pulmonary Medicine, Fortis Escorts Heart Institute and Research Centre, New Delhi, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deepanshu","family":"Chawla","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine, Fortis escorts Heart Institute, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simran","family":"Jaglan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Fortis Escorts Heart Institute, New Delhi, Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aman","family":"Karim","sequence":"additional","affiliation":[{"name":"Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,5]]},"reference":[{"key":"2025082709010747000_17.12.e263039.1","doi-asserted-by":"crossref","first-page":"362","DOI":"10.5001\/omj.2011.89","article-title":"Ewing\u2019s Sarcoma Presenting as Pleural Effusion","volume":"26","author":"Kushwaha","year":"2011","journal-title":"Oman Med J"},{"key":"2025082709010747000_17.12.e263039.2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/jcm10081685","article-title":"Ewing Sarcoma-Diagnosis, Treatment, Clinical Challenges and Future Perspectives","volume":"10","author":"Z\u00f6llner","year":"2021","journal-title":"J Clin Med"},{"key":"2025082709010747000_17.12.e263039.3","article-title":"A primary Ewing\u2019s sarcoma of pleura: Case report and literature review","volume":"34","author":"Zou","year":"2021","journal-title":"Respir Med Case Rep"},{"key":"2025082709010747000_17.12.e263039.4","first-page":"1733","article-title":"Extra-skeletal Ewing Sarcoma of the chest wall in a child","volume":"23","author":"Mathew","year":"2019","journal-title":"SA J Radiol"},{"key":"2025082709010747000_17.12.e263039.5","doi-asserted-by":"crossref","first-page":"20220669","DOI":"10.1515\/biol-2022-0669","article-title":"Primary mediastinum Ewing\u2019s sarcoma with pleural effusion: A case report and literature review","volume":"18","author":"Li","year":"2023","journal-title":"Open Life Sci"},{"key":"2025082709010747000_17.12.e263039.6","doi-asserted-by":"crossref","first-page":"547","DOI":"10.4103\/lungindia.lungindia_280_23","article-title":"Ewing\u2019s sarcoma of rib presenting as pleural effusion in a young child","volume":"40","author":"Bisen","year":"2023","journal-title":"Lung India"},{"key":"2025082709010747000_17.12.e263039.7","doi-asserted-by":"crossref","first-page":"284","DOI":"10.4236\/jct.2022.135024","article-title":"Pleural Effusion Revealing Bone Ewing Sarcoma: About Three Cases","volume":"13","author":"Anane","year":"2022","journal-title":"JCT"},{"key":"2025082709010747000_17.12.e263039.8","doi-asserted-by":"crossref","first-page":"2632010X20970210","DOI":"10.1177\/2632010X20970210","article-title":"Ewing Sarcoma With Emphasis on Extra-skeletal Ewing Sarcoma: A Decade\u2019s Experience From a Single Centre in India","volume":"13","author":"Murthy","year":"2020","journal-title":"Clin Pathol"},{"key":"2025082709010747000_17.12.e263039.9","first-page":"363","article-title":"Massive pleural effusion in an 18-year-old girl with Ewing sarcoma","volume":"11","author":"Ozge","year":"2004","journal-title":"Can Respir J"},{"key":"2025082709010747000_17.12.e263039.10","first-page":"1","article-title":"Pleural Effusion Revealing a Diagnosis of Ewing Sarcoma","volume":"13","author":"Ali","year":"2021","journal-title":"Cureus"},{"key":"2025082709010747000_17.12.e263039.11","doi-asserted-by":"publisher","DOI":"10.1007\/s00776-014-0687-z"},{"key":"2025082709010747000_17.12.e263039.12","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.rcl.2011.05.006","article-title":"Imaging pediatric bone sarcomas","volume":"49","author":"Kaste","year":"2011","journal-title":"Radiol Clin North Am"},{"key":"2025082709010747000_17.12.e263039.13","doi-asserted-by":"crossref","unstructured":"Mata Fern\u00e1ndez C , Sebio A , Orcajo Rinc\u00f3n J , et al . Clinical practice guidelines for the treatment of Ewing sarcoma (Spanish Sarcoma Research Group-GEIS). Clin Transl Oncol 2024. doi:10.1007\/s12094-024-03602-5","DOI":"10.1007\/s12094-024-03602-5"},{"key":"2025082709010747000_17.12.e263039.14","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.27011","article-title":"Recurrence of Ewing sarcoma: Is detection by imaging follow-up protocol associated with survival advantage?","volume":"65","author":"Heinemann","year":"2018","journal-title":"Pediatr Blood Cancer"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-263039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:01:13Z","timestamp":1756310473000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-263039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12]]},"references-count":14,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2024,12,5]]},"published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1136\/bcr-2024-263039"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-263039","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2024,12]]}}}