Authors’ reply to Kumar

We thank Kumar for her interest and critical comments in our article "Primary Ewing's sarcoma of the orofacial region: A narrative review."[1,2] We would like to address each of her valuable comments. In our narrative review, two authors performed hand-searching of articles and two-step literature screening. The literature search was done in databases from 2011 to 2022 to include articles published in the past 10 years. Studies published in English language only were included in the review, and other foreign-language articles were excluded. We acknowledge that a recent case report on Ewing's sarcoma of the mandibular condyle by Kudva et al.[3] was not included. Kudva et al.[3] from India reported a case of Ewing's sarcoma in the mandibular condyle of a 22-year-old patient who presented with non-painful swelling and fever. Magnetic resonance imaging revealed a hyperintense lesion in the ramus with loss of fat planes. The histopathological features showed islands of round cells with irregular nuclei and pale eosinophilic cytoplasm. The tumor was positive for cluster of differentiation 99 (CD99), synaptophysin, and friend leukemia integration 1 transcription factor (FLI-1). Four cycles of chemotherapy with cyclophosphamide, doxorubicin, and vincristine were administered, and the patient succumbed after 2 months. We entirely accept that Ewing's sarcoma may also manifest atypically as common odontogenic complaints in a few cases where conventional radiography has a role in the initial diagnostic process. Furthermore, in response to the author's question on radiographic findings, we could have stated the type of radiographic findings more specifically. In a panoramic radiograph, Ewing's sarcoma usually presents as ill-defined lytic lesions of the tumor-involved site with a moth-eaten appearance. The paranasal sinus view reveals radiolucency in the tumor-involved site with discontinuity and haziness in the sinus. We concur with the author on adhering to references and citations concerning the age of the patients and genetic translocation. Our review included 3 (21.4%) children under 5 years of age,[4-6] and the rest of the patients were adolescents and young adults. Ewing's sarcoma is characterized by oncogenic translocation of chromosomes t(11;22) (q24;q12), resulting in the chimeric fusion transcript EWS-FLI1. In our study, we found a case with translocation t(21;22) (q22;q12).[2,7] We also admit that the citation does not seem to be appropriate to reference number 20. Chemotherapy with vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide (VDCIE) effectively treats newly diagnosed Ewing's sarcoma.[8] Sinha et al.[9] presented a case in the lower jaw for which two cycles of chemotherapy with cyclophosphamide, doxorubicin, and vincristine were given after surgical mandibulectomy. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.