Ewing Sarcoma

Spinal Ewing sarcoma is an uncommon tumor usually seen in the second decade of life with male predilection. In adolescents, an aggressive solitary osteolytic lesion with a soft tissue mass in the sacrum and less commonly in vertebra should raise suspicion for Ewing sarcoma. Spinal MRI is sensitive in the early detection of Ewing sarcoma and the evaluation of tumor spread to the bone marrow or into adjacent soft tissues. Sacrococcygeal tumors have a poor prognosis. Treatment should be multimodal involving radical surgical excision, radiotherapy, and chemotherapy.