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Archives de pédiatrie
Volume 22, n° 6
pages 626-629 (juin 2015)
Doi : 10.1016/j.arcped.2015.03.007
Received : 25 August 2014 ;  accepted : 13 Mars 2015
Tumeur d’Ewing de localisation mandibulaire. À propos d’un cas
Ewing sarcoma located in the mandible: A case report

M. Hernandez a, , D. Droz a, L. Mansuy b, E. Simon c, P. Chastagner b
a Département d’odontologie pédiatrique, CHU de Nancy, 2, rue du Docteur-Heydenreich, 54000 Nancy, France 
b Département d’hémato-oncologie pédiatrique, hôpital Brabois-Enfants, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France 
c Département de chirurgie maxillo-faciale, hôpital central, CHU de Nancy, 29, avenue du Maréchal-de-Lattre-de-Tassigny, 54000 Nancy, France 

Auteur correspondant.

Le sarcome d’Ewing est une tumeur osseuse ou extra-osseuse maligne rare qui peut intéresser tous les os du squelette, mais plus particulièrement les os plats. La douleur est très souvent le symptôme révélateur, accompagnée ou non d’une tuméfaction et justifie la prescription d’imageries médicales loco-régionales complétées par une biopsie. Certaines présentations peuvent être trompeuses du fait de leur localisation atypique et/ou de l’absence de douleur. Nous présentons le cas d’un enfant de 7ans atteint d’un sarcome d’Ewing localisé à la mandibule, diagnostiqué devant une tuméfaction mandibulaire d’apparition progressive sans symptomatologie douloureuse.

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Ewing sarcoma is the second most common primary malignant bone cancer in children and adolescents. Clinical presentation is usually dominated by local pain and a palpable mass. These symptoms justify imaging investigations: the first one, when an osseous lesion is suspected, is usually a conventional radiograph in two planes. Ewing sarcoma appears as a poorly defined osteolytic lesion that may frequently be associated with cortical erosion or laminar periosteal response (“onion skin”). However, this aspect is not pathognomonic and the definitive diagnosis is made by biopsy. Absence of pain or an unusual localization can lead to misdiagnosis. We report the case of a 7-year-old boy with Ewing sarcoma located in the mandible with a clinical picture including progressive mandibular swelling but no pain.

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