Case Report: Uncommon presentation of Ewing sarcoma complicated by hemophagocytic lymphohistiocytosis: a diagnostic dilemma and therapeutic challenge

Hemophagocytic lymphohistiocytosis (HLH), also referred to as hemophagocytic syndrome (HPS), is a life-threatening condition characterized by excessive immune activation. It is commonly associated with genetic mutations, infections, autoimmune diseases, and malignancies. Malignancy-associated HLH (M...

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Main Authors: Zhuan Zou, Bin Chen, Fajuan Tang, Xihong Li, Chengshuang Huang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1613906/full
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author Zhuan Zou
Zhuan Zou
Bin Chen
Bin Chen
Fajuan Tang
Fajuan Tang
Xihong Li
Xihong Li
Chengshuang Huang
Chengshuang Huang
author_facet Zhuan Zou
Zhuan Zou
Bin Chen
Bin Chen
Fajuan Tang
Fajuan Tang
Xihong Li
Xihong Li
Chengshuang Huang
Chengshuang Huang
author_sort Zhuan Zou
collection DOAJ
description Hemophagocytic lymphohistiocytosis (HLH), also referred to as hemophagocytic syndrome (HPS), is a life-threatening condition characterized by excessive immune activation. It is commonly associated with genetic mutations, infections, autoimmune diseases, and malignancies. Malignancy-associated HLH (M-HLH) is most frequently observed in hematologic malignancies, such as lymphoma and leukemia, while its occurrence in solid tumors is exceedingly rare. Here, we report a unique case of temporal bone Ewing sarcoma complicated by HLH and Epstein-Barr virus (EBV) infection. Despite intensive chemotherapy, the patient ultimately succumbed to multi-organ failure and septic shock. To the best of our knowledge, this is the first documented case of Ewing sarcoma associated with HLH.
format Article
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institution Kabale University
issn 2234-943X
language English
publishDate 2025-08-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Oncology
spelling doaj-art-e9fd7ac569cd4218870a21b9e5ea7ae62025-08-20T03:59:45ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-08-011510.3389/fonc.2025.16139061613906Case Report: Uncommon presentation of Ewing sarcoma complicated by hemophagocytic lymphohistiocytosis: a diagnostic dilemma and therapeutic challengeZhuan Zou0Zhuan Zou1Bin Chen2Bin Chen3Fajuan Tang4Fajuan Tang5Xihong Li6Xihong Li7Chengshuang Huang8Chengshuang Huang9Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaDepartment of Emergency, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaDepartment of Emergency, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaDepartment of Emergency, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaDepartment of Emergency, West China Second University Hospital, Sichuan University, Chengdu, ChinaKey Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, ChinaHemophagocytic lymphohistiocytosis (HLH), also referred to as hemophagocytic syndrome (HPS), is a life-threatening condition characterized by excessive immune activation. It is commonly associated with genetic mutations, infections, autoimmune diseases, and malignancies. Malignancy-associated HLH (M-HLH) is most frequently observed in hematologic malignancies, such as lymphoma and leukemia, while its occurrence in solid tumors is exceedingly rare. Here, we report a unique case of temporal bone Ewing sarcoma complicated by HLH and Epstein-Barr virus (EBV) infection. Despite intensive chemotherapy, the patient ultimately succumbed to multi-organ failure and septic shock. To the best of our knowledge, this is the first documented case of Ewing sarcoma associated with HLH.https://www.frontiersin.org/articles/10.3389/fonc.2025.1613906/fullhemophagocytic lymphohistiocytosisextraosseous ewing sarcomacase reportEpstein-Barr virus (EBV)malignancy-associated HLH
spellingShingle Zhuan Zou
Zhuan Zou
Bin Chen
Bin Chen
Fajuan Tang
Fajuan Tang
Xihong Li
Xihong Li
Chengshuang Huang
Chengshuang Huang
Case Report: Uncommon presentation of Ewing sarcoma complicated by hemophagocytic lymphohistiocytosis: a diagnostic dilemma and therapeutic challenge
Frontiers in Oncology
hemophagocytic lymphohistiocytosis
extraosseous ewing sarcoma
case report
Epstein-Barr virus (EBV)
malignancy-associated HLH
title Case Report: Uncommon presentation of Ewing sarcoma complicated by hemophagocytic lymphohistiocytosis: a diagnostic dilemma and therapeutic challenge
title_full Case Report: Uncommon presentation of Ewing sarcoma complicated by hemophagocytic lymphohistiocytosis: a diagnostic dilemma and therapeutic challenge
title_fullStr Case Report: Uncommon presentation of Ewing sarcoma complicated by hemophagocytic lymphohistiocytosis: a diagnostic dilemma and therapeutic challenge
title_full_unstemmed Case Report: Uncommon presentation of Ewing sarcoma complicated by hemophagocytic lymphohistiocytosis: a diagnostic dilemma and therapeutic challenge
title_short Case Report: Uncommon presentation of Ewing sarcoma complicated by hemophagocytic lymphohistiocytosis: a diagnostic dilemma and therapeutic challenge
title_sort case report uncommon presentation of ewing sarcoma complicated by hemophagocytic lymphohistiocytosis a diagnostic dilemma and therapeutic challenge
topic hemophagocytic lymphohistiocytosis
extraosseous ewing sarcoma
case report
Epstein-Barr virus (EBV)
malignancy-associated HLH
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1613906/full
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