Presentation
In the present study, nine cases presented with the symptoms of fever, cough with chest pain and suffocation, while two cases presented with a mass in the chest and throat. Short-term symptoms progressed rapidly, with an average of 10–20 days. [spandidos-publications.com]
Conclusion Askin’s tumor is a rare tumor of childhood which usually presents with common respiratory symptoms. Pediatrician must be far sighted to suspect this rare entity with such common presentations. [hindawi.com]
The common presentation in patients with askin's tumor is chest pain, respiratory distress or a chest wall mass [3]. Rarely, It may present as pathological fracture or metastasis related symptoms [5]. [panafrican-med-journal.com]
A history of tubercular contact was present in her mother 4 years back. [ncbi.nlm.nih.gov]
Visit our Pediatric Community CASE SUMMARY A previously healthy 9-year-old male presented with a several-week history of progressive shortness of breath. [appliedradiology.com]
Entire Body System
- Localized Pain
It may include cough, chest pain, fever, breathlessness, and so forth. Local pain may be present which might reduce in intensity at night but not disappear completely. [hindawi.com]
Respiratoric
- Aspiration
Fine needle aspiration cytologic findings in malignangt small cell tumor of the thoracopulmonay region (Askin tumors). Acta Cytol. 1994; 38: 702-6. PubMed | Google Scholar Christopher DM, Fletcher K, Krishnan U, Fredrik M. [panafrican-med-journal.com]
Fine needle aspiration cytology (FNAC) from the mass lesion showed small blue round cells with monomorphous salt and pepper appearing chromatin and large and inconspicuous nuclei, suggestive of primitive neuroectodermal tumor—likely Askin’s tumor (Figure [hindawi.com]
View Article : Google Scholar : PubMed/NCBI 13 Kumar PV: Fine needle aspiration cytologic findings in malignant small cell tumor of the thoracopulmonary region (Askin tumor). [spandidos-publications.com]
- Painful Cough
Askin tumor may present as a chest wall mass with thoracopulmonary symptoms such as chest pain, cough, or dyspnea. [jtcvs.org]
Patient and observation An 18 years old male presented with a five months history of left chest pain, cough and dyspnea. He had previously been in good health. [panafrican-med-journal.com]
- Hemoptysis
There was no history of breathlessness, cough, hemoptysis, or weight loss. His past history and family history were unremarkable. Radiograph of the chest PA view showed large homogenous opacity covering almost the entire right hemithorax. [hindawi.com]
Musculoskeletal
- Fracture
Rarely, It may present as pathological fracture or metastasis related symptoms [5]. General symptoms like fever, anorexia and weight loss may occur. Other modes of revelations are even rarer. [panafrican-med-journal.com]
It may present with local paraesthesia and rarely as pathological fracture or metastasis related symptoms [1, 9]. In the cases presented, the manifestation was purely like any lower respiratory tract infections. [hindawi.com]
However, symptoms may also include a chest wall mass, pleural effusion, superficial lymph nodes and rib fractures. Askin's tumor has the characteristics of a high degree of malignancy, poor efficacy and easy local recurrence. [spandidos-publications.com]
Psychiatrical
- Suggestibility
Chest radiograph PA view showed a large homogenous opacity on right upper lobe, suggestive of a mass lesion (Figure 1). [hindawi.com]
From our preliminary data, we suggest that Askin tumor should be treated with complete surgical excision followed by an aggressive chemotherapy regimen. [jtcvs.org]
Chest CT imaging (Figure 2) showed a heterogenous mass of 19X13 cm in the right hemithorax with hypodense areas suggestive of necrosis .There was associated pleural effusion and infiltration of the soft parts of the chest wall. [panafrican-med-journal.com]
The presence of pleural effusion was poor prognostic factor, but localized disease, age (14 years), good response to initial cycle of chemotherapy were favorable factors suggesting good outcome in this patient. [ncbi.nlm.nih.gov]
Cellular and molecular genetics studies have suggested that PNET has a characteristic chromosomal translocation t (11:22)(q24; q12), which provides an additional firm diagnostic criterion for Askin's tumor (16,17). [spandidos-publications.com]
Workup
It requires immunohistochemical workup supported by imaging investigations. Treatment is not yet codified. However, surgery is predominant. The Prognosis is poor. We describe a case of a 18 year old male without metastatic disease at presentation. [panafrican-med-journal.com]
Treatment
Therefore, the survival ratio was significantly improved in the combined treatment group compared with that of the single treatment group (P<0.05). [spandidos-publications.com]
Treatment of Askin's tumor should be multimodal, requiring discussion in multidisciplinary tumor working groups. The treatment includes chemotherapy, radiotherapy and surgery. [panafrican-med-journal.com]
So it is of utmost importance to make an early diagnosis and proper referral/treatment in such cases. We highlighted diagnostic challenge, treatment, and favorable outcome of a case that presented to us. [ncbi.nlm.nih.gov]
Lewis et al., “Results of the EICESS-92 study: two randomized trials of Ewing's sarcoma treatment-cyclophosphamide compared with ifosfamide in standard risk patients and assessment of benefit of etoposide added to standard treatment in high risk patients [hindawi.com]
Patients and methods Table 1Patients with Askin tumor: Primary site and treatment Case (age [y], sex) Chief symptom Primary site Treatment for primary tumor 1 (32, F) Abnormal shadow on chest film Right posterior pleura Chest wall resection with 4 ribs [jtcvs.org]
Prognosis
We believe that this prognosis would have been better if the diagnosis was made earlier, allowing surgical excision. [panafrican-med-journal.com]
However, recent genetic research has led to the conclusion that it is essentially the same as Ewing sarcoma, and now is part of the collective term Ewing sarcoma family of tumors, sharing similar demographics, imaging findings and prognosis 2,3. [radiopaedia.org]
Univariate analysis revealed that poor prognosis was associated with a tumor diameter >5 cm, LDH levels >240 U/l and late stage (stage III or IV) tumors. [spandidos-publications.com]
It would require a high index of suspicion on behalf of the general pediatrician for the early recognition of this tumor so that chances of better outcome and prognosis shall be there. [hindawi.com]
Crossref PubMed Scopus (500) Google Scholar Askin tumors typically involve the periosteum, soft tissues, and extrapulmonary tissue of the thoracic wall, and the prognosis is very poor. 2 Contesso G Llombert-Bosch A Terrier P Peydro-Olaya A Henry-Amar [jtcvs.org]
Etiology
With this case report we hope to highlight the importance of keeping in mind askin tumors as one etiologic possibility of chest wall tumor. Early diagnosis could improve the prognosis. [panafrican-med-journal.com]