SARCOME D'EWING EPIDURAL : DIAGNOSTIC, PRISE EN CHARGE ET RESULTATS CHIRURGICAUX AU SERVICE DE NEUROCHIRURGIE DU CHU D'ANNABA

Abstract

Ewing's sarcoma is a rare malignant tumor in children and adolescents, most often osseous. Its spinal
epidural location is scarce (<1%) and constitutes a neurological emergency. This study aims to describe the
clinical, radiological, and evolutionary characteristics of this particular entity, and to discuss its management in
light of international data. We conducted a retrospective study involving 5 patients aged 8 to 32, who were
followed at Ibn Rochd University Hospital in Annaba between 2009 and 2023. Demographic, clinical, imaging,
histological, and therapeutic data were analyzed. All patients underwent decompression surgery, followed by
chemotherapy according to the VDC/IE protocol. Survival was assessed descriptively. Three patients were female
(60%) and two were male (40%). All presented with spinal cord compression. RI allowed for rapid detection, and
diagnostic confirmation was obtained through histology in 100% of cases patients presented with metastases at
diagnosis. The progression Summary was marked by partial or complete neurological recovery in 4 patients. At a
median follow-up of 18 months, the overall survival was 80%. A local recurrence was observed. The difference
according to sex was not significant (p =0.67). Epidural Ewing's sarcoma remains a rare but formidable form
requiring urgent multidisciplinary management. Our series, although limited, confirms the effectiveness of a
combined surgery-chemotherapy treatment. Early diagnosis remains crucial for functional prognosis. The
establishment of multicentric registries is necessary to better understand this entity and improve its management in
resource-limited countries