title: [Ewing's sarcoma of the mandible in children: reconstruction by induced membrane].
abstract: BACKGROUND
  Ewing's sarcoma (ES) is a malignant bone neoplasm that develops during the first two decades of life, and affects male more than female patients (sex ratio 1.6/1). ES head and neck bone localization is extremely uncommon (2 to 4%). We report a rapid induced membrane reconstruction without primary bone autograft.
  
  
  METHODS
  A 7-year-old boy presented with a 50mm mandibular ES centered on the horizontal branch of the right mandible. This patient was treated by a combination of neo-adjuvant chemotherapy, surgery, and adjuvant radio-chemotherapy, according to the Euro-Ewing 99 protocol. The right horizontal mandibular branch was resected, following induction chemotherapy. A macroplate and a cement spacer were used for the reconstruction, while expecting anatomopathological results. Seventeen days later, we removed the spacer because of scar disunion. The radiographic controls revealed a spontaneous osteogenesis along the macroplate despite the early cement spacer removal. This spontaneously bone growth allowed avoiding a free vascularized bone transfer for the reconstruction. The tissue regeneration potential of this young boy and the cement spacer induced membrane could explain this spontaneous osteogenesis phenomenon.
  
  
  CONCLUSIONS
  Induced membrane can be added to the therapeutic options for pediatric oncologic mandibular bone loss. It avoids using of a free vascularized bone transfer.
authors.affiliation: Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France. Electronic address: t.sorin@chu-nancy.fr.
authors.forename: T
authors.initials: T
authors.lastname: Sorin
authors.affiliation: Service d'hématologie et oncologie pédiatrique, hôpitaux de Brabois, CHU de Nancy, 5, rue du Morvan, 54500 Vandœuvre-lès-Nancy, France.
authors.forename: L
authors.initials: L
authors.lastname: Mansuy
authors.affiliation: Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: T
authors.initials: T
authors.lastname: Colson
authors.affiliation: Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France.
authors.forename: C
authors.initials: C
authors.lastname: Minetti
authors.affiliation: Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 34, cours Léopold, 54052 Nancy, France.
authors.forename: M
authors.initials: M
authors.lastname: Brix
authors.affiliation: Service de chirurgie plastique et maxillo faciale, hôpital Central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France; Université de Lorraine, 34, cours Léopold, 54052 Nancy, France.
authors.forename: E
authors.initials: E
authors.lastname: Simon
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001861:Bone Regeneration / Q000502:physiology; D059186:Chemoradiotherapy, Adjuvant; D002648:Child; D003131:Combined Modality Therapy; D048091:Guided Tissue Regeneration / Q000379:methods; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008339:Mandibular Neoplasms / Q000628:therapy*; D009061:Mouth Mucosa / Q000473:pathology; D020360:Neoadjuvant Therapy; D010012:Osteogenesis / Q000502:physiology; D019651:Plastic Surgery Procedures; D012512:Sarcoma, Ewing / Q000628:therapy*; D013524:Surgical Flaps
keywords: Child; Enfant; Ewing's sarcoma; Guided tissue regeneration; Mandible; Mandibule; Neoplasm; Régénération tissulaire guidée; Sarcome d’Ewing; Tumeur