{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:51:16Z","timestamp":1782489076413,"version":"3.54.5"},"reference-count":15,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,2,26]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Ewing sarcoma (ES) and its variants are rare and aggressive malignancies, occurring in paediatric and younger adult populations. Adamantinoma-like ES (ALES) is one of its variants, characterised by\n                    <jats:italic>EWSR1::FLI1<\/jats:italic>\n                    fusions, and is exceptionally rare, especially in older adults. There are a few similar cases reported in the literature. We report a rare case of an older adult with a complicated medical history and reported a left neck mass on a follow-up visit; the mass developed over nine months. After evaluation, he was found to have a rare diagnosis of ALES in this age group, specifically with this Ewing Sarcoma RNA binding protein 1 and nuclear factor of activated T cells cytoplasmic 2 (\n                    <jats:italic>EWSR1::NFATC2<\/jats:italic>\n                    ) gene fusion. This case highlights the challenges of diagnosing and the multidisciplinary management of rare variants of ES with uncommon gene fusions and raises awareness for the future potential of molecular diagnostics and treatment-specific applications for improved access to care and better outcomes for this population.\n                  <\/jats:p>","DOI":"10.1136\/bcr-2025-268120","type":"journal-article","created":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T16:05:16Z","timestamp":1775145916000},"page":"e268120","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Neck mass in an elderly patient with EWSR1::NFATC2 gene fusion"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4180-6812","authenticated-orcid":false,"given":"Amber E","family":"Faquih","sequence":"first","affiliation":[{"name":"Anesthesiology and Perioperative Medicine, The University of Alabama at Birmingham Health System, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eeman","family":"Noor","sequence":"additional","affiliation":[{"name":"Internal Medicine, Swat Medical College, Saidu Sharif, KPK, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bilal","family":"Jawed","sequence":"additional","affiliation":[{"name":"Internal Medicine, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mennatallah","family":"Ewais","sequence":"additional","affiliation":[{"name":"Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aasim","family":"Sehbai","sequence":"additional","affiliation":[{"name":"Alabama Cancer Care of Anniston, Anniston, Alabama, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"2026062608151736000_19.4.e268120.1","unstructured":"American Cancer Society . Cancer facts & figures 2020. Atlanta: American Cancer Society; 2020. Available: https:\/\/www.cancer.org\/research\/cancer-facts"},{"key":"2026062608151736000_19.4.e268120.2","doi-asserted-by":"crossref","unstructured":"Anderson ME , DuBois SG , Gebhardt MC . Sarcomas of bone. In: Abeloff MD , Armitage JO , Niederhuber JE , et al , eds. Abeloff\u2019s clinical oncology. Philadelphia: Elsevier, 2020: 1604\u201354.","DOI":"10.1016\/B978-0-323-47674-4.00089-X"},{"key":"2026062608151736000_19.4.e268120.3","unstructured":"DeLaney TF , Hornicek FJ , Bahrami A . Epidemiology, pathology, and molecular genetics of the ewing sarcoma family of tumors. Waltham (MA): UpToDate, 2020."},{"key":"2026062608151736000_19.4.e268120.4","doi-asserted-by":"publisher","DOI":"10.1177\/1066896911405320"},{"key":"2026062608151736000_19.4.e268120.5","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000167056.13614.62"},{"key":"2026062608151736000_19.4.e268120.6","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-019-01098-y"},{"key":"2026062608151736000_19.4.e268120.7","doi-asserted-by":"crossref","DOI":"10.1177\/17588359231165979","article-title":"Adamantinoma-like Ewing sarcoma of the salivary glands: a case report and systematic literature review","volume":"15","author":"Lauricella","year":"2023","journal-title":"Ther Adv Med Oncol"},{"key":"2026062608151736000_19.4.e268120.8","doi-asserted-by":"crossref","first-page":"134","DOI":"10.9734\/jcti\/2024\/v14i4275","article-title":"Adamantinoma-like Ewing Sarcoma: A Report of Two Rare Cases in the Pancreatic Tail and Spine","volume":"14","author":"Barodawala","year":"2024","journal-title":"J Can Tumor Int"},{"key":"2026062608151736000_19.4.e268120.9","first-page":"129","article-title":"Adamantinoma-like Ewing sarcoma of thyroid gland-An unfamiliar mimicker of epithelial and mesenchymal neoplasms of the head and neck","volume":"45","author":"Mohammed","year":"2023","journal-title":"Malays J Pathol"},{"key":"2026062608151736000_19.4.e268120.10","doi-asserted-by":"crossref","DOI":"10.1155\/2019\/9386390","article-title":"EWSR1-NFATC2 and FUS-NFATC2 Gene Fusion-Associated Mesenchymal Tumors: Clinicopathologic Correlation and Literature Review","volume":"2019","author":"Bode-Lesniewska","year":"2019","journal-title":"Sarcoma"},{"key":"2026062608151736000_19.4.e268120.11","unstructured":"de Alava E , Lessnick SL , Stamenkovic I , et al . WHO classification of tumours: soft tissue and bone tumours. 5th edn. Lyon: IARC Press, 2020:323\u20135."},{"key":"2026062608151736000_19.4.e268120.12","doi-asserted-by":"crossref","DOI":"10.1097\/00000478-199902000-00004","article-title":"Adamantinoma-like Ewing\u2019s sarcoma: genomic confirmation, phenotypic drift","volume":"23","author":"Bridge","year":"1999","journal-title":"Am J Surg Pathol"},{"key":"2026062608151736000_19.4.e268120.13","doi-asserted-by":"crossref","first-page":"192","DOI":"10.25259\/IJMSR_34_2024","article-title":"An atypical presentation of Ewing\u2019s sarcoma of the scapula in an elderly male: A case report","volume":"7","author":"Shaikh","year":"2024","journal-title":"IJMSR"},{"key":"2026062608151736000_19.4.e268120.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.canlet.2006.12.009"},{"key":"2026062608151736000_19.4.e268120.15","doi-asserted-by":"crossref","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"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268120","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T15:21:11Z","timestamp":1782487271000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":15,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,4,2]]},"published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1136\/bcr-2025-268120"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268120","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]}}}