Atypical presentation of Ewing sarcoma mimicking osteomyelitis in a 14-year-old male

Ewing’s sarcoma, is the most common malignancy in children involving the long bones second only to osteosarcoma. This highly malignant disease predominantly affects adolescents and is difficult to diagnose due to its location, presentation and the age group involved. The commonest misdiagnosis considered in a case of ES would be osteomyelitis due to the similarity in blood and serum biochemical findings seen in these two inflammatory conditions. Here we report a case of a 14-year-old boy who was diagnosed as osteomyelitis and was treated for the same. This case report highlights an atypical facet of the natural history of Ewing’s sarcoma: transient response to antibiotic therapy and anti-inflammatory agents, and the limited stage of the disease despite a significant delay in diagnosis.