Chest Wall Reconstruction in Ewing Sarcoma Using a Radioprotective Spacer.

introductionEwing sarcoma is a rare malignant tumor that primarily affects children and adolescents, and approximately 20% occur in the chest wall, where achieving local control is challenging due to the need for extensive resection and the proximity to vital organs. Adjuvant radiotherapy improves outcomes but carries a risk of severe complications such as radiation pneumonitis. Radioprotective spacers have been used for abdominal and pelvic tumors, but their use in chest wall tumors is rarely reported. We report a chest wall Ewing sarcoma case in which a radioprotective spacer using expanded polytetrafluoroethylene and a water-inflatable expander was placed to reduce radiation-related organ damage. CASE PRESENTATION: A 15-year-old female presented with a large Ewing sarcoma arising from the left chest wall, measuring 121 × 166 × 93 mm. After diagnosis by wedge biopsy and confirmation of

conclusionsThis case illustrates the feasibility and safety of combining a radioprotective spacer with structural chest wall reconstruction in pediatric sarcoma. The dual‑purpose design may offer an effective strategy for minimizing radiation‑related toxicity in thoracic tumors requiring multimodal treatment.