MANDIBLE EWING SARCOMA IN A 7-YEAR-OLD BOY: CLINICAL, RADIOGRAPHIC, AND DIAGNOSIS CONSIDERATIONS

Ewing sarcoma (ES) is an aggressive form of bone/soft tissue cancer, and it is the second most frequent tumor in children and young adults, being very rare in jawbones. The aims of the present study are to emphasize the radiographic features of ES affecting the mandible and discuss the main differential diagnosis. A 7-year-old boy presented with a growth in the chin region with 2 months’ of duration. Tomography showed a poorly delimited osteolytic lesion affecting the anterior region of the mandible, which caused tooth displacement. Moreover, periosteal reaction called sunburst phenomenon and moth-eaten aspect were also observed. Incisional biopsy was performed, and histopathologic and immunohistochemical features were consistent of ES. Treatment consisted of 14 chemotherapy cycles, resection of the anterior region of the mandible, and reconstruction with a fibula free flap. The patient is asymptomatic after 1 year from the surgery, and there is no evidence of local/systemic diseases.