Unilateral Decreased Visual Acuity as the Initial Manifestation of Ewing Sarcoma : the Key Role of Imaging

Authors

Alia Yassine Kassab, Mehdi Salmane, Lina Lasri, Hounayda Jerguigue, Youssef Omor, Rachida Latib

Journal Information

Journal: Medpeer Publisher

ISSN: 3066-2737

Volume: 3

Issue: 1

Date of Publication: 2026/01/26

DOI: 10.70780/medpeer.000QGR4

Abstract

Ewing sarcoma is a malignant bone tumor predominantly affecting children and adolescents, most commonly involving long bones and the pelvis. Cranial involvement is rare and may present with misleading clinical signs. We report the case of a 17-year-old patient who presented with progressive decreased visual acuity, followed by unilateral exophthalmia and headache, without prior oncological history. Computed tomography (CT) revealed an aggressive osteolytic lesion centered on the right greater wing of the sphenoid, responsible for cortical destruction, with extension into the surrounding soft tissues and orbit. Histopathology confirmed the diagnosis of Ewing sarcoma. This case highlights the critical role of CT imaging in detecting atypical cranial presentations of Ewing sarcoma and guiding timely diagnosis, biopsy, and multidisciplinary management.

Keywords

Ewing sarcoma, Visual Acuity, Unilateral exophthalmia, Cranial vault, Sphenoid bone, Computed tomography, Case report