Laparoscopic resection of retro gastric extra osseous Ewing Sarcoma in a 5-year old: a rare case and review of literature

Ewing sarcoma is a highly aggressive pediatric bone tumor that most commonly affects children and adolescents. It is characterized by the chromosomal translocation t(11;22)(q24;q12), resulting in the EWSR1-FLI1 fusion gene, and is typically associated with strong CD99 immunopositivity. Involvement of visceral organs, particularly the gastrointestinal tract, is extremely rare and remains underreported in literature. We present a case of a 5-year-old female with an unusual retro-gastric extraosseous Ewing sarcoma (EES). The diagnosis was confirmed via histopathological analysis following clinical and radiological evaluation The patient was treated with systemic chemotherapy followed by surgical management. This case highlights a rare and atypical presentation of visceral EES originating from the stomach in the pediatric age group. Also, this case demonstrates the feasibility of laparoscopic resection in pediatric visceral EES following neoadjuvant chemotherapy.