CNS involvement in Ewing's sarcoma

Ewing's sarcoma is an unocommon malignant neoplasm of the bone. Metastatic CNS involvement in this disease has been only rarely mentioned. Out of 27 patients in this series, 15 patients had one or more neurologic symptoms. The most common neurologic symptom was headache, and the most common sign was papilledema. These patients should have an adequate minimal workup, perhaps only a brain scan, and should receive prompt radiotherapy to alleviate their symptomatology. Six out of 7 patients in this series who received palliative radiotherapy showed significant symptomatic relief. With present aggressive local radiotherapy to the primary disease, combined with the chemotherapy, the outlook has improved. With improves survival more patients will present with CNS metastatic disease. We concur with Johnson9 about prophylactic CNS treatment with radiation to supplement the chemotherapy. It is interesting to note that out of 6 patients who received total body irradiation, only on developed frontal headache as the only neurologic symptom.