International Session 51　　Sinonasal tumor

Background : Ewing sarcoma(ES)is a small round-cell tumor typically arising in bones.While treatment includes surgery, chemotherapy, and radiotherapy, recurrent ES invading the orbit or skull base is challenging to manage.Case : An 18-year-old female was diagnosed with right maxillary sinus ES at year X-5, receiving chemotherapy and proton beam therapy.Local recurrence occurred at year X-1 around the right maxillary sinus ; she underwent neoadjuvant chemotherapy, total maxillectomy, and free flap transfer.At year X, second recurrence extended to the right orbit and skull base, causing severe headache and visual loss.After multidisciplinary discussion, anterolateral craniofacial resection with orbital exenteration and free flap transfer was performed uneventfully.Discussion : Orbit-and skull base-involving resections are highly invasive with major functional and cosmetic deficits.However, this patient's severe orbital pain resolved post-surgery.Surgical indications for recurrent ES require careful discussion with patient and family, weighing invasiveness against symptom relief.