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Background <p>Ewing’s sarcoma (ES) of the mandible is an uncommon malignancy in paediatric maxillofacial oncology. Conventional therapy involves neoadjuvant chemotherapy before resection; however, in urgent situations with airway compromise or rapid functional decline, a <i>surgery-first</i> protocol may be warranted.</p> Case Presentation <p>An eight-year-old girl presented with a rapidly enlarging mandibular mass causing trismus and facial asymmetry. Imaging and biopsy confirmed ES. Multidisciplinary consensus favoured immediate surgery due to impending airway obstruction. Segmental mandibulectomy with primary reconstruction was performed, followed by six cycles of VAC/IE chemotherapy and adjuvant intensity-modulated radiotherapy (IMRT).</p> Follow-Up <p>Recovery was uneventful with restoration of oral function. At two-year follow-up, the patient remains disease-free with excellent facial symmetry and normal thoracic imaging.</p> Conclusion <p>This report highlights that, in function-threatening paediatric mandibular ES, a surgery-first strategy may safely preserve airway and function while maintaining oncologic control. Flexible sequencing of multimodal therapy should be considered when functional compromise is imminent.</p>

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Case Report of Ewing’s Sarcoma of the Mandible in a Pediatrics Patient: Diagnostic Challenges and Multimodal Management

  • 期刊论文

  • 发表日期：

    2025年12月6日

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  • Chandrashekhar Chattopadhyay,
  • Vikas Deo,
  • Charu Chouhan,
  • Mamta Patel,
  • Priti Airun,
  • Sugandha Jain

摘要

Background

Ewing’s sarcoma (ES) of the mandible is an uncommon malignancy in paediatric maxillofacial oncology. Conventional therapy involves neoadjuvant chemotherapy before resection; however, in urgent situations with airway compromise or rapid functional decline, a surgery-first protocol may be warranted.

Case Presentation

An eight-year-old girl presented with a rapidly enlarging mandibular mass causing trismus and facial asymmetry. Imaging and biopsy confirmed ES. Multidisciplinary consensus favoured immediate surgery due to impending airway obstruction. Segmental mandibulectomy with primary reconstruction was performed, followed by six cycles of VAC/IE chemotherapy and adjuvant intensity-modulated radiotherapy (IMRT).

Follow-Up

Recovery was uneventful with restoration of oral function. At two-year follow-up, the patient remains disease-free with excellent facial symmetry and normal thoracic imaging.

Conclusion

This report highlights that, in function-threatening paediatric mandibular ES, a surgery-first strategy may safely preserve airway and function while maintaining oncologic control. Flexible sequencing of multimodal therapy should be considered when functional compromise is imminent.