Ewing sarcoma of the mandible in a child-reconstruction using a chondrocostal graft

Ewing sarcoma is a rare malignant bone tumour that predominantly affects long and flat bones; mandibular involvement is exceptional. We report the case of a 14-year-old boy presenting with a firm, painless right cheek mass that progressively enlarged over 7 months. Clinical examination revealed a mass extending ~9 cm intraorally. The patient underwent surgical excision via vestibular hemimandibulectomy, followed by immediate reconstruction using a chondrocostal graft fixed to a titanium plate, alongside neoadjuvant and adjuvant chemotherapy. Histopathological and immunohistochemical analyses confirmed the diagnosis. At the 6-month follow-up, there has been no evidence of recurrence, and the patient has maintained satisfactory facial symmetry and oral function. This case highlights the importance of including Ewing sarcoma in the differential diagnosis of paediatric cheek masses and demonstrates that chondrocostal grafting is a viable reconstructive option in growing patients.