Ewing's sarcoma of mandible: A case report and review of Indian literature
An 8-year-old girl visited the Department of Oral Pathology of this institution with 7-month history of a painless, gradually increasing swelling in the mandibular anterior region. The lesion was previously attempted for surgery elsewhere and regional teeth were extracted. Extraorally, a hard nontender swelling (4 × 2 cm) was observed on the lower one third of the anterior mandible which was covered by normal appearing skin []. Intraoral examination revealed involvement of mandibular alveolar ridge with expansion of both the cortical plates []. Overlying mucosa was centrally erythematous and nonulcerated. The mass was hard in consistency with a fluctuant area wherefrom blood tinged fluid was aspirated. The patient was apparently healthy with no sign of paresthesia or lymphadenopathy.\nOPG revealed an ill-defined mixed radiodensity lesion extending from right first premolar to left deciduous second molar involving the crypts of permanent canines []. Destruction of cortical plates and ‘sun–ray’ appearance radiating from the lower border of mandible was also appreciated. Clinical and radiological features suggested a destructive lesion with a suspicion of malignancy. Routine hemogram and biochemical examination revealed no abnormality. Incisional biopsy was done after obtaining consent. Microscopy revealed sheets of small round cell population scattered in a scanty fibrovascular stroma. Individual cells exhibited hyperchromatic nuclei with infrequent mitotic figures surrounded by peripheral rim of scanty cytoplasm [] Immunohistochemistry showed strong positivity for CD99.\nbut no expression for LCA []. Histopathological and immunohistochemical findings supported the diagnosis of ES.