CASE 44: CT CHEST

12 M with non resolving opacity in left chest

FINDINGS REVEAL

Minimally ehancing chest wall mass lesion eroding the left 3rd rib, with extra pulmonary soft tissue extension. Small left pleural effusion is seen.

IMPRESSION

Findings are suggestive of a chest wall / rib tumor - ASKIN's / PNET/ EWING GROUP OF TUMORS

Discussion

These tumours may either arise in the osseous structures of the chest wall (ribs, scapula, sternum of clavicle) or less frequently in the soft tissues of the chest (it was these latter lesions that were described as Askin's tumors.

Peripheral primitive neuroectodermal tumor of the chest wall is a rare malignant tumor usually occurring in children. The tumor shares a similar histology, immunohistology and cytogenetics to Ewing’s sarcoma. 

Peripheral primitive neuroectodermal tumor (pPNET) of the chest wall belongs to the Ewing’s sarcoma family due to their genotypic and phenotypic appearance 

The characteristic CT picture in the patient with Askin tumor/pPNET is that of a heterogenous mass of chest wall origin with areas of necrosis and hemorrhage with or without an intrathoracic component 

Further reading 

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