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Kargar Shooroki K, Hajialiloo Sami S, HamidzadehKhiavi A, Sour B, Movahedi M S, Roshanravan B. Extraskeletal Ewing’s Sarcoma of the Foot in a Pediatric Patient: A Case Report. JROS 2025; 12 (2) :91-96
URL: http://jros.iums.ac.ir/article-1-2305-en.html

Background: Extraskeletal Ewing’s sarcoma (EES), described in 1969 by Tefft et al., is an extremely uncommon collection of highly malignant cells that typically manifests in pediatrics and adolescents, with most cases ranging between 10 and 20 years old. Patients usually present with swelling and localized pain associated with a rapidly growing mass.
Case Presentation: This study aimed to report a case of EES of the foot in a 4-year-old Iranian boy, who was admitted with pain and a wart-like lesion on the plantar surface of his left foot over the past 4 months. Magnetic resonance imaging (MRI) revealed a subcutaneous soft tissue mass in the area between the first and second toes, extending from the plantar surface to the dorsal aspect of the foot. The core-needle biopsy results were indicative of EES. A tourniquet was applied to the proximal part of the lower extremity during surgery. After the surgery and subsequent histology evaluation, EES was confirmed.
Conclusion: Although EES is an uncommon entity, it is important to consider this tumor in the differential diagnosis of skin subcutaneous lesions, especially in younger individuals and if there is a visible cutaneous lesion. These tumors are sometimes clinically misdiagnosed because they resemble other cutaneous cancers on examination. Given the rarity of EES, there is no standard and definite guideline for management, and EES requires multidisciplinary care in order to achieve the best outcomes in management.