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A 7-year-old boy presented to the neurosurgery clinic with left leg weakness. Enhanced
multidetector computed tomography and magnetic resonance imaging were performed. Multidetector
computed tomography images revealed a mass with minimal contrast enhancement that
extended into the left L3–L4 foramen and psoas muscle (Fig. 1). Magnetic resonance images revealed a mass that was isointense on T1-weighted images
and hyperintense on T2-weighted images compared with muscle (Fig. 2, Fig. 3), with homogenous enhancement after contrast administration (Fig. 2, Fig. 3), consistent with nerve sheath tumors. Pathologic specimens obtained at surgery showed
Ewing sarcoma that has imaging features similar to nerve sheath tumors. Extraskeletal
Ewing sarcoma is rare but has been reported [
Fig. 1(Left) Axial and (Right) sagittal reformatted multidetector computed tomography images
of a 7-year-old boy showed lumbar mass (white arrows) that pushed left psoas muscle
and expanded L3–L4 neural foramens (black arrows).
Fig. 2(Left) Axial T2-weighted (T2W), (Middle) T1-weighted (T1W), and (Right) postcontrast
T1W magnetic resonance images of a 7-year-old boy showed isointense mass on T1W and
hyperintense on T2W images and homogeneous contrast enhancement. Mass expanded the
neural foramen and pushed the left psoas muscle.
Fig. 3(Left) Sagittal T2-weighted (T2W), (Middle) T1-weighted (T1W), and (Right) postcontrast
T1W magnetic resonance images of a 7-year-old boy showed isointense mass on T1W and
hyperintense on T2W images and homogenous contrast enhancement.
