Ewing's Sarcoma Presenting in the Paranasal Sinus - A Case Report.

Abstract

Rationale: The aim of this study is to raise awareness among dentists regarding a potential outcome associated with the rapid growth of facial swellings.

Patient concerns: We present a case of Ewing's sarcoma (ES) in a 23-year-old male who presented with a rapidly progressive swelling in the left maxillary region over six weeks.

Diagnosis: There was no significant intraoral dental finding other than a missing left upper first molar. Panoramic imaging initially suggested chronic sinusitis, but the swelling persisted despite treatment. A subsequent cone-beam computed tomography (CBCT) scan revealed a soft-tissue tumour affecting multiple sinuses, confirmed by an open biopsy as a small round cell tumour. Immunohistochemistry was used for precise diagnosis due to biopsy sample limitations and tumour variability.

Treatment: The patient's case was reviewed by our institution's tumour board. One month after diagnosis, chemotherapy began with alternating drugs for a total of 6 cycles.

Outcomes: A follow-up Positron Emission Tomography (PET)/Computed Tomography (CT) scan after two months of chemotherapy showed resolution of the hypermetabolic mass on the left side without evidence of metastatic disease. The patient is currently under regular follow-up.

Take-away lessons: Dentists should be vigilant for rapidly expanding oral or facial swellings. Early and accurate diagnosis can improve clinical management and survival rates for ES patients.