Ewing sarcoma of the mandibular condyle: multidisciplinary management optimizes outcome.
BACKGROUND
Ewing sarcoma (ES) is a rare, primary malignancy of bone that occurs in childhood and early adolescence. Improved methods of diagnosis and treatment have dramatically increased survival over the last 20 years. Treatment mainstays are chemotherapy and surgical tumor resection. ES usually occurs in long bones of the axial skeleton; however, it may rarely arise in facial structures, particularly the mandible. In these cases, resection presents a challenging postsurgical reconstruction.


RESULTS
We present the clinical findings and management of a case of ES that developed in the left mandibular condyle of a 15-year-old female. Chemotherapy and segmental mandibulectomy were used to achieve local control. An innovative temporomandibular joint reconstruction was successfully accomplished using a microvascular fibular free flap and conchal cartilage graft.


CONCLUSIONS
Multidisciplinary management in diagnosis, treatment, and restoration of function produced an optimal result that eliminated disease and preserved aesthetics and quality of life.
Solomon
Lynn W
LW
Department of Oral and Maxillofacial Pathology, Tufts University School of Dental Medicine, Boston, Massachusetts, USA. lynn.solomon@tufts.edu
Frustino
Jennifer L
JL
Loree
Thom R
TR
Brecher
Martin L
ML
Alberico
Ronald A
RA
Sullivan
Maureen
M
D000293:Adolescent; D002356:Cartilage / Q000637:transplantation; D017024:Chemotherapy, Adjuvant; D004954:Esthetics; D005260:Female; D005360:Fibula / Q000637:transplantation; D006801:Humans; D008334:Mandible / Q000601:surgery; D008339:Mandibular Neoplasms / Q000473:pathology / Q000628:therapy*; D010348:Patient Care Team; D012512:Sarcoma, Ewing / Q000473:pathology / Q000628:therapy*; D013524:Surgical Flaps / Q000098:blood supply