Don Young Park, Edwin Batista and Lawrence A Rinsky
Ewing's sarcoma is a malignant bone tumor that affects children typically in their second decade, with a low incidence in patients less than five years of age. Presenting symptoms may be nonspecific and may include pain, swelling, fever, and weight loss. Definitive diagnosis may be difficult and further investigation may be necessary to differentiate Ewing's sarcomas with osteomyelitis. We present a case report of a three year-old boy with Ewing's sarcoma that involved the entire right humerus. Due to his young age, and nonspecific nature of his presentation, the patient was initially misdiagnosed and treated for osteomyelitis. The patient required multi-agent chemotherapy and radical en-bloc resection of the entire right humerus, given the extent of his tumor involvement. A custom expandable modular humeral prosthesis was designed and engineered specifically for this patient. His arm is very functional three years postoperatively, and he is disease free. To our knowledge, this is the youngest report of Ewing's sarcoma that required total humeral resection and prosthetic replacement presented in the literature.