A Rare Case of Tibiofemoral Ewing's Sarcoma Recurrence with Lung Metastasis 27 Years after Initial Diagnosis.

Introduction: Ewing's sarcoma (ES) is a rare, malignant small round-cell tumor. Some of the patients will experience local or distant recurrent illness. To detect early incidental or unexpected distant metastasis during the follow-up or initial evaluation, Fluorine-18-fluorodeoxyglucose (18F-FDG) PET/computed tomography (PET-CT) plays a significant role and has the potential to impact clinical judgments as well as forecast the prognosis and resectability of ES patients.

Case presentation: We report the case of a 44-year-old patient who present a history of a treated ES located in left tibiofemoral articulation whom presented a recurrence and a metastatic tibiofemoral ES in the lung 27 years after his diagnosis and first management.

Conclusion: Due to this risk of recurrence, ES needs a regular monitoring and follow-up. We propose a monitoring by 18F-FDG PET/CT-Scan once a year during 5 years then one time every 2 years to be able to detect early metabolic lesions.