Primary Intracranial Ewing Sarcoma: Case Series and Review of Literature

S Saravanan, Rathikinda Srinivasulu, Swarnaakshari, Bonigala Siddhardha Mourya

Abstract: Primary intracranial extraosseous Ewing sarcoma is one of those rare and elusive tumours that often hides behind the mask of more common intracranial lesions, making timely diagnosis particularly challenging. In my view, what makes this condition so striking is not just its aggressive nature but also the ease with which it can be misinterpreted as central primitive neuroectodermal tumours or even benign findings such as hematomas. This paper presents three diverse cases two in children and one in an adult where the tumour manifested in different ways, from dural-based masses infiltrating bone and muscle to deep-seated lesions mimicking diffuse gliomas. It is evident that radiological appearances alone could not provide clarity, and only a combination of histopathology, immunohistochemistry (especially CD99 expression), and molecular insights into the EWSR1 rearrangement made the diagnosis possible. That said, the treatment outcomes varied depending on the extent of surgical resection and the integration of radiotherapy or chemotherapy, which highlights the importance of a multidisciplinary approach. Taking this further, one cannot ignore the sobering reality that despite advances in surgical precision and supportive care, prognosis often remains guarded, with recurrence and neurological complications being frequent hurdles. This suggests that while the current multimodal strategies bring hope, there is still much ground to cover in understanding the biological behaviour of this tumour. In essence, these cases not only reinforce the diagnostic complexity of intracranial Ewing sarcoma but also remind us of the pressing need for tailored treatment protocols that balance aggressive intervention with long-term quality of life.

Keywords: Ewings sarcoma, round cell tumours

How to Cite?: S Saravanan, Rathikinda Srinivasulu, Swarnaakshari, Bonigala Siddhardha Mourya, "Primary Intracranial Ewing Sarcoma: Case Series and Review of Literature", Volume 14 Issue 8, August 2025, International Journal of Science and Research (IJSR), Pages: 1280-1285, https://www.ijsr.net/getabstract.php?paperid=SR25822190127, DOI: https://dx.doi.org/10.21275/SR25822190127