Ewing sarcoma (ES) is one of the most frequent primary bone tumors and has a well-studied diagnostically important genetic background. However, there are primary bone round-cell tumors with atypical morphology different from conventional ES, tumors with rearrangement of the EWSR1 gene with partner genes not from the ETS gene family, tumors with unusual changes in the EWSR1 gene (amplification or deletion), which can cause significant diagnostic difficulties. In this article, we will describe a case of a primary bone tumor with an atypical morphology similar to myoepithelial carcinoma, where an amplification of the EWSR1 gene was detected. According to morphological, immunological, genetic and clinical signs, this tumor was classified as a sarcoma from the EWSR1::non-ETS group of round-cell sarcomas, namely a sarcoma with EWSR1::NFATC2 rearrangement, first formalized in the WHO classification of soft tissue tumors in 2020.

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Breast asymmetry is a polyetiological condition, which may be caused by congenital characteristics, developmental abnormalities, hormonal changes, traumas or surgery. The estimation of breast symmetry should be performed by the plastic surgeon while planning the augmentation or reduction mammoplasty as well as reconstructive surgery. Breast asymmetry is a widespread condition, according to some reports, it can be found in more than half of women. Anthropometric methods, as well as radiology methods, are used to diagnose and estimate breast asymmetry. There are many classification systems of breast asymmetry. The first ones were based on breast appearance or etiology of asymmetry, while modern classifications combine morphologic and etiologic principles. Today there is no conventional diagnostic protocol for breast asymmetry, where it would be listed, which breast parameters should be measured during breast asymmetry estimation. The first attempts were made in the middle of the XX century. Works of Penn, Smith and Westreich are considered to be basic in this field. Generally, relationships between major breast soft-tissue reference points (nipple, areola, submammary fold, lateral border) and bone structures (breastbone, jugular notch, clavicle) are estimated.Mathematic formulas for counting breast volume depending on its linear measurements were developed as well. Nowadays the importance of skeleto-muscular system state (the presence of scoliosis or rib cage deformation) estimation is emphasized, while these conditions can also cause breast asymmetry.