Keshani Forouz, Jahanshahi Gholamreza, Attar Bijan Movahedian, Kalantari Mahsa, Razavi Seyed Mohammad, Hashemzade Zahra, Tavakoli Payam
Dental Caries Prevention Research Center, Qazvin University of Medical Sciences, Isfahan, Iran.
Department of Oral and Maxillofacial Pathology, School of Dentistry, Isfahan, Iran.
Adv Biomed Res. 2014 Jan 27;3:62. doi: 10.4103/2277-9175.125841. eCollection 2014.
Ewing's sarcoma is a rare malignant neoplasm that comprises approximately 4-6% of primary bone tumors. In most cases, femur and pelvis are affected, and less commonly the head and neck areas (in the jaws, usually the mandible). These tumors have been reported more frequently in males, mostly aged 5-20 years old. Systemic symptoms and signs such as fever, weight loss, anemia, leukocytosis, and elevated erythrocyte sedimentation rate (ESR) may be the first signs in oral Ewing's sarcoma. Such signs and symptoms are also seen in odontogenic infections and abscess. In one case, the patient went to a dentist with pain, swelling, and abscess similar to odontogenic infection and patient's tooth was pulled due to misdiagnosis. This tumor has an aggressive clinical behavior and is identified with rapid growth and high probability of metastasis at diagnosis. Thus, it is necessary to differentiate it from a dental abscess. As for the treatment of Ewing's sarcoma, first the tumor must undergo chemotherapy to reduce its size and, eventually, it undergoes extensive surgery. This case report deals with a 16-year-old patient wrongly diagnosed with odontogenic infection and abscess, and hospitalized. As the symptoms did not remit, biopsy was carried out and the patient was operated on with Ewing's sarcoma diagnosis.
尤因肉瘤是一种罕见的恶性肿瘤，约占原发性骨肿瘤的4%-6%。在大多数情况下，股骨和骨盆会受到影响，而头颈部区域（在颌骨中，通常是下颌骨）较少受累。据报道，这些肿瘤在男性中更为常见，大多数患者年龄在5至20岁之间。全身症状和体征，如发热、体重减轻、贫血、白细胞增多和红细胞沉降率（ESR）升高，可能是口腔尤因肉瘤的首发症状。这些症状在牙源性感染和脓肿中也可见。有一例患者因疼痛、肿胀和脓肿去看牙医，症状类似牙源性感染，由于误诊，患者的牙齿被拔除。这种肿瘤具有侵袭性的临床行为，在诊断时表现为生长迅速且转移概率高。因此，有必要将其与牙源性脓肿区分开来。至于尤因肉瘤的治疗，首先肿瘤必须接受化疗以缩小其大小，最终进行广泛的手术。本病例报告涉及一名16岁患者，最初被误诊为牙源性感染和脓肿并住院。由于症状未缓解，进行了活检，最终患者在诊断为尤因肉瘤后接受了手术。
