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Preoperative chemotherapy is essential for conservative surgery of Askin tumors.

Askin tumors are highly malignant thoracopulmonary tumors mainly occurring in children and adolescents. An aggressive multimodal approach (chemotherapy, surgery and radiotherapy) is the common treatment.1,2 Takanami and associates3 recently reported on 2 long-surviving patients with Askin tumors first treated by surgery. They suggested that the best treatment schedule was surgery followed by chemotherapy, with or without radiotherapy, highlighting the issue of the best timing of chemotherapy in this disease. In our opinion many reasons justify the use of chemotherapy in a preoperative setting, including a safer and simpler surgery and the possibility to use information about tumor chemosensitivity to plan postoperative chemotherapy and radiotherapy. On this basis we treated Askin tumor with a multimodal approach that included induction chemotherapy. Here we present our favorable results with this schedule of treatments and briefly review salient literature data.