Treatment of Mandibular Ewing’s Sarcoma in a Child: A Rare Case and Literature Review

Ewing’s sarcoma (ES) is a malignant bone tumor that frequently occurs in the pelvis and long bone; it rarely occurs in the head and neck region. We report the good results of treatment for ES of the mandible in a child. A 14-year-old Japanese girl was referred to our hospital by her family dentist because of swelling, pain, and dysesthesia in the left mandible. A dental infection was suspected based on the initial symptoms, but imaging suggested a neoplastic lesion. A tissue biopsy and genetic testing revealed the ES. We consulted our hospital’s pediatrics department to develop a treatment plan. Following the treatment protocol, chemotherapy (VDC-IE: vincristine, doxorubicin, cyclophosphamide, ifosfamide, etoposide) was administered; resection would be performed if operable, and postoperative chemotherapy and radiation therapy were planned if necessary. First, six courses of chemotherapy were given. The patient’s general condition was good, the tumor had shrunk, and surgery was feasible; resection with reconstruction of the mandible was thus performed. Postoperatively, the patient did not receive radiotherapy, but instead received eight courses of scheduled chemotherapy. About 4 years have passed since the treatment with no recurrence or metastasis, and occlusal reconstruction with dental implants has also been performed.