ArticleSurgical neurology international2026
Primary spinal epidural undifferentiated round cell sarcoma with Ewing-like features in an 8-year-old child: Diagnostic challenges and recovery after subtotal resection.
Article in Surgical neurology international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Primary epidural extraosseous Ewing sarcoma (EES) is exceptionally rare in children. Some tumors display the morphological and immunophenotypic features of EES but lack the canonical Ewing sarcoma breakpoint region 1 (EWSR1) rearrangement, creating a diagnostic dilemma. Case Description: An 8-year-old girl presented with worsening nocturnal lumbosacral pain, paraparesis (3/5), and urinary incontinence. Magnetic resonance imaging revealed a large dumbbell-shaped epidural mass extending from L3 to S1 with homogeneous contrast enhancement. Emergency L2-S1 laminotomy allowed piecemeal subtotal resection because of intimate circumferential adherence to the dura mater and emerging nerve roots. Histopathology demonstrated small round blue cells with strong CD99 positivity, whereas markers for lymphoma, neuroblastoma, and rhabdomyosarcoma were negative. Fluorescence Conclusion: This case illustrates the diagnostic and therapeutic challenges posed by Ewing-like sarcomas in the absence of molecular confirmation. Function-preserving subtotal resection combined with multimodal chemotherapy may lead to excellent outcomes and may be preferable to radical resection when the latter carries a high neurological risk.
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