Primary Intracranial Ewing Sarcoma Arising from the Cavernous Sinus in an Older Woman with a History of Intensive Breast Cancer Treatment: A Case Report

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  • KADOTA Yoshihito
    Department of Radiology, Faculty of Medicine, University of Miyazaki
  • ODA Yoshinao
    Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University
  • AKIYAMA Yuri
    Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University Department of Diagnostic Pathology, National Hospital Organization Kyushu Cancer Center
  • AZUMA Minako
    Department of Radiology, Faculty of Medicine, University of Miyazaki
  • YAMASHITA Atsushi
    Division of Pathophysiology, Department of Pathology, Faculty of Medicine, University of Miyazaki
  • OKITA Yoshiko
    Department of Neurosurgery, Faculty of Medicine, University of Miyazaki
  • YAMASHITA Shinji
    Department of Neurosurgery, Faculty of Medicine, University of Miyazaki
  • OGURI Nobuyuki
    Division of Pathophysiology, Department of Pathology, Faculty of Medicine, University of Miyazaki
  • KAWANO Tomoki
    Department of Neurosurgery, Faculty of Medicine, University of Miyazaki
  • AKIZUKI Keiichi
    Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki
  • TOMONAGA Takumi
    Department of Anatomic Pathology, Graduate School of Medical Sciences, Kyushu University
  • MATSUMOTO Fumitaka
    Department of Neurosurgery, Faculty of Medicine, University of Miyazaki

Bibliographic Information

Published
2025-12-31
Resource Type
journal article
DOI
  • 10.2176/jns-nmc.2025-0138
Publisher
The Japan Neurosurgical Society

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<p>A 72-year-old woman with a history of breast cancer presented with left oculomotor nerve palsy. Magnetic resonance imaging revealed a progressive mass lesion in the cavernous sinus. Initially, Tolosa-Hunt syndrome and metastatic brain tumor from breast cancer were suspected; however, radiological differentiation proved challenging. Pathological examination confirmed the diagnosis of primary intracranial Ewing sarcoma. The tumor exhibited progressive growth, and Gamma Knife radiosurgery was performed. After treatment, tumor shrinkage and symptomatic improvement were observed. Ewing sarcoma typically occurs in children and young adults; however, the safety and efficacy of chemotherapy in older populations remain largely unstudied. In this older patient, the rare location of the tumor within the cavernous sinus posed challenges to surgical resection. Chemotherapy was administered at a reduced dose of 50%, with limited side effects. After 7 cycles of chemotherapy, tumor showed further shrinkage, and no recurrence was observed. This case demonstrates that, even in rare tumors with unestablished chemotherapy protocols for older patients, satisfactory outcomes can be achieved with accurate pathological diagnosis and a multidisciplinary treatment approach.</p>

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