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Ewing Sarcoma
Case Detail
| Anatomy: Neck-Face |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Neoplasia Malignant |
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| Created: over 3 years ago |
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| Updated: over 2 years ago |
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| Tags:
PEDS
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| Modality/Study Types:
MR
CT
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Activities:  PDF  ImageJA |
History
12 year old male with a mass arising from the roof of the mouth.
Case Images
Diagnosis
Ewing sarcoma
Findings
CT – Axial bone and coronal soft tissue postcontrast images demonstrate osseous destruction and soft tissue mass. Note the “floating” tooth.
MR – Axial and coronal post-gadolinium images of the face demonstrate heterogenous mass filling the left maxillary sinus extending through the pterygoid plate and palate into the nasopharynx.
Discussion
The ramus of the mandible is the most common site of Ewing sarcoma of the The ramus of the mandible is the most common location for Ewing sarcoma of the head and neck. The typical manifestations are a rapidly growing mass with associated pain and local paresthesias. Mandibular involvement may cause additional associated symptoms, such as loosening of teeth and otitis media. Images of Ewing sarcoma and osteogenic sarcoma show large soft-tissue masses that originate in the marrow, permeate and destroy the cortical bone, and extend into the masticator space. The extent of bone marrow involvement is best evaluated with T1-weighted imaging, whereas T2-weighted imaging is of value for defining the margins of the tumor and its relation to neurovascular bundles and adjacent muscle.
Reference
Khanna G, et al. Causes of Facial Swelling in Pediatric Patients: Correlation of Clinical and Radiologic Findings. RadioGraphics, Jan 2006; 26: 157 – 171.