Very Late Relapse of Ewing Sarcoma in a Developing country

Abstract

Ewing sarcoma (ES) is a rare cancer effecting children and young adults. Prognosis varies from 30 -70%. Relapse can occur within 2 years of initial diagnosis, although very late relapses have been reported. Our index patient was successfully managed for chest wall Primitive Neuroectodermal tumour (PNET) in infancy by good multidisciplinary care and later presented after seven years with very late relapse of Ewing sarcoma (ES). This is the longest duration to relapse reported in any developing country. Management was challenging. His first relapse was successfully treated with Irinotecan and temozolamide based chemotherapy with complete surgical resection and chest radiotherapy. He remained well for 18 months before being presented with a second relapse that’s also successfully managed. There is dire need to share experiences in managing such patients & start doing clinical trials for optimal management of such patients in developing countries to build local expertise.