Ewing's sarcoma: primary involvement of the zygoma undergoing resection and immediate reconstruction.

Because the occurrence of primary Ewing's sarcoma in the facial bones is unusual, it may pose diagnostic and therapeutic problems. Lack of clinical suspicion along with atypical radiographic features may lead to a delayed diagnosis. Furthermore, because of the limited number of cases, precise treatment guidelines are lacking. In our patient, whom we believe to be the first reported with primary Ewing's sarcoma originating in the zygoma, the tumor was successfully managed surgically. A combination of craniofacial and microsurgical principles made surgical resection and immediate reconstruction possible in an area not generally thought to be amenable to surgery; moreover, we thus avoided the potential deleterious effects of radiation in the facial region in a growing child.