Rigid titanium-polypropylene reconstruction enabling R0 resection in pediatric chest wall Ewing's sarcoma

Chest wall Ewing's sarcoma in children presents surgical challenges because radical resection needed for oncological clearance often creates large defects that compromise respiratory mechanics. We report a pediatric case managed with neoadjuvant chemotherapy followed by en bloc resection of the ribs, medial clavicle, and part of the sternum with wedge lung resection, and subsequent reconstruction using titanium plates and polypropylene mesh, achieving microscopically margin-negative (R0) resection and excellent functional recovery.