Aggressive Ewing Sarcoma of the Mandible in a Child: A Case Report

Ewing sarcoma is a highly aggressive malignant bone tumor which most commonly arises in the long bones and pelvis of adolescents and young adults.Craniofacial involvement, particularly of the mandible, is extremely rare and may mimic odontogenic or inflammatory lesions, leading to diagnostic delay.We report the case of a 14-year-old girl with histologically confirmed Ewing sarcoma of the left mandible.Clinical and initial radiological findings suggested an aggressive mandibular lesion with locoregional extension.For comprehensive baseline evaluation, an 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) was performed.It demonstrated intense metabolic activity of the mandibular mass, consistent with high tumor aggressiveness, while excluding cervical, thoracic, abdominal, and skeletal metastases.This case underlines the crucial role of 18 F-FDG PET/CT not only in the initial staging of Ewing sarcoma but also in the differential diagnosis of atypical mandibular swellings in children and adolescents.By combining functional and anatomical data, PET/CT improves diagnostic confidence, guides therapeutic planning, and contributes to prognostic assessment in such uncommon presentations.