Ewing sarcoma of clavicle in children: report of 5 cases

Ewing sarcoma accounts for about 2% to 3% of childhood tumors and can occur in any bone, but it is most often found in extremities and central axis. Ewing sarcoma affecting clavicle is uncommon. We report 5 cases of Ewing sarcoma of clavicle treated in our institution. The mean age at the time of diagnosis was 11.6 years (2 to 15 y). There were 3 males and 2 females. All patients received chemotherapy before and after the surgery. Likewise, radiotherapy was administrated after tumor excision in one patient. Different methods of surgical treatment were used and included: claviculectomy, claviculectomy and vascularized fibular autograft, and claviculectomy and clavicle allograft. One patient died during the follow-up because of the recurrence of the tumor and presence of metastatic disease. The remaining 4 patients had good functional outcomes with no pain of the shoulder at final follow-up. In conclusion, Ewing sarcoma of clavicle is a very rare tumor and different methods of surgical treatment can be used. Clavicle often can be resected with no need for reconstruction, especially in young children. Autografts or allografts can restore the normal anatomy of the shoulder.