Extraosseous Ewing sarcoma in the fossa jugular: A rare case report

Figure 1:. A 15-year-old boy, with a mass like “horn” came from acoustic externus.

Figure 2:. Head computed tomography with contrast in axial view soft-tissue solid mass enhancement, irregular border, in the right jugular fossa, and exophytic.

Figure 3:. Head computed tomography with contrast in coronal view, soft-tissue solid mass enhancement, irregular border, like in the right jugular fossa that exophytic to the middle ear, meso, and hypotympanum until right external meatus, with destruction in the right mastoid and right temporal.

Figure 4:. Head magnetic resonance imaging with contrast axial and coronal view, there is hyperintense on T1-weighted image, a mass was seen destroying the right mastoid, right temporal bone, and part of the sphenoid, visible intracranial extradural extension.

Figure 5:. Head magnetic resonance imaging with contrast axial and coronal view, hyperintense with prominent flow voids forming a salt and pepper image on T2-weighted image, unrestricted diffusion in the diffusion-weighted imaging area, which did not show contrast enhancement, a mass was seen destroying the right mastoid, right temporal bone and part of the sphenoid looks intracranial extradural extension.

Figure 6:. The mass is seen feeding from the superficial temporal segment and the posterior auricular artery segment of the right external carotid artery branch.

Figure 7:. (a) Pre Embolization and (b) Post embolization intra-arterial embolization were done at the maxillary artery, middle deep temporal branch, meningeal accessories artery, and occipital artery use 250 micron–355 microparticle.

Figure 8:. A small uniform primitive cell with round nuclei and scanty cytoplasm appearance.