Combined modality treatment of Ewing's sarcoma of the maxilla.
BACKGROUND
Primary bone sarcomas arising in osseous structures of the head and neck are rare. These tumors are often incompletely resected and treated with radiotherapy for local control.


METHODS
We report a case of a 9-year-old girl with a maxillary Ewing's sarcoma. This patient was successfully treated with neoadjuvant chemotherapy followed by surgical resection and prosthetic reconstruction of the primary site. The surgical approach that was used consisted of a subtotal maxillectomy by means of a facial degloving approach, sparing the orbital contents and the inferior orbital rim and orbital floor.


RESULTS
This approach produced excellent cosmetic, functional, and oncologic outcome. The patient remains without evidence of disease recurrence more than 4 years after surgery.


CONCLUSIONS
This case illustrates a novel surgical approach to the resection of a maxillary Ewing's sarcoma and highlights the need for a multidisciplinary team approach to the management of head and neck sarcomas in children.
Wexler
Leonard H
LH
Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, Box 210, New York, New York 10021, USA. wexler@mskcc.org
Kacker
Ashutosh
A
Piro
John D
JD
Haddad
Joseph
J
Close
Lanny G
LG
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002648:Child; D005260:Female; D006801:Humans; D008437:Maxilla / Q000601:surgery; D008441:Maxillary Neoplasms / Q000188:drug therapy* / Q000601:surgery*; D008447:Maxillofacial Prosthesis; D020360:Neoadjuvant Therapy; D012512:Sarcoma, Ewing / Q000188:drug therapy* / Q000601:surgery*