Abstract
Ewings sarcoma of the hand is relatively rare. Ewings sarcoma can present with minimal
pain and swelling of the affected digit. The Erythrocyte sedimentation rate and Creactive
protein may be high. Radiologically, Ewings sarcoma can present with a plethora of
features from permeative bone destruction to expansile lesions with or without periosteal
reaction. Because of these features, this can be confused with Tuberculosis especially
in a country like ours where Tuberculosis is endemic. This leads to starting of inappropriate
treatment and delay in diagnosis. We report a case of an 18 year old boy who was initially
diagnosed as Tuberculous dactylytis of the proximal phalanx of the little finger.
He was started on anti-tuberculous treatment and did not respond to it. Subsequent
investigation in our centre which also included an open biopsy, confirmed the diagnosis
of Ewings sarcoma. He was treated with ray excision, and chemotherapy. This case is
being presented for its rarity and also to emphasize the fact that an open biopsy
in suspected cases would be appropriate to confirm the diagnosis. This would prevent
delay in diagnosis of rare conditions like Ewings sarcoma.
Keywords
Ewings sarcoma - Hand - Dactylytis
