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Image and pathological features of Ewing's sarcoma in the oral and maxillofacial region.

OBJECTIVE
To systematically evaluate the image and pathological features of Ewing's sarcoma (ES) in the oral and maxillofacial region. 


METHODS
Eight patients with ES in the oral and maxillofacial region were enrolled for this study. The X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) of ES and the pathological data were systematically evaluated. 


RESULTS
X-ray image showed a diffuse radiolucency with cystic component and ill-defined borders for bone lesion. CT showed that there was osteolytic mass with extensive bone destruction and soft tissue infiltration, but no periosteal reactions were observed. MRI demonstrated that ES showed an inhomogeneous structure and blurred borders with invasion to adjacent soft tissue for bone lesion. Similar manifestation also showed in MRI images for patients with soft tissues. Histologically, ES composed of small round cells, and expressed CD99, neuron specific enolase (NSE) and vimentin (Vim) in all patients. Desmin (Des), CD34, epithelial membrane antigen (EMA), chromogranin A (ChgA), etc, were negatively expressed in ES cells. 


CONCLUSION
X-ray, CT, and MRI are helpful to determine the property, extent and the relationship of ES with the surrounding tissues. Immunohistochemical stain of CD99, NSE, and Vim are helpful to confirm the pathological diagnosis of ES.