A rare case of Ewing sarcoma appearing in an adrenal gland rather than bones was documented by Upstate doctors.

Health professionals who work at academic medical centers such as Upstate Medical University often share their expertise and the information they learn from taking care of patients. Their work is presented at medical conferences and published in medical journals.

Here is a recent finding:

Ewing sarcoma is an aggressive cancer that is most common in children and young adults. It usually affects the long bones. Rarely, this cancer may be detected elsewhere, outside of the skeletal system.

In research published in the journal Radiology Case Reports, a group of doctors from Upstate points out that this cancer can show up in the adrenal gland.

Their patient was a 34-year-old man who had abdominal and flank pain for a couple of weeks. Medical images revealed a mass pressing on the right kidney. It might have been a bruise, because the man remembered an injury from a while ago, but the doctors also considered several types of tumors. Then they completed additional imaging tests and saw that the mass was extending into the inferior vena cava, the large vessel that returns blood from the lower body to the heart, and they knew the mass had to be removed – and quickly.

The man underwent a massive operation, requiring three surgical teams. The mass, his right adrenal gland and kidney were removed, along with his gallbladder, some of his liver and diaphragm, some lymph nodes and a clot that was in his vena cava. His heart stopped during the surgery, and he was revived. He had a lengthy and complicated recovery, which radiologist Mujtaba Mohammed, MD, and colleagues detail in their paper.

Pathologists found evidence of Ewing sarcoma in the mass, and it had invaded the man’s liver and vena cava. Three months later, medical images showed no evidence of cancer recurrence. Mohammed reported that the patient was improving during chemotherapy.

“This case demonstrates the importance for early detection and diagnosis of Ewing sarcoma of the adrenal gland with medical imaging,” he wrote.