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Abstract：
Ewing\'s sarcoma is a rare and highly aggressive bone tumor primarily affecting children and adolescents. It commonly presents in the pelvic and axial skeleton, with sacral involvement posing unique challenges due to its intricate anatomical location. This report details the case of an 18-year-old male with sacral Ewing\'s sarcoma, emphasizing the diagnostic, surgical, and reconstructive aspects of management. The patient presented with lower back pain, lower limb weakness, and urinary incontinence, which prompted an extensive diagnostic evaluation. Magnetic resonance imaging and computed tomography scans revealed a large lytic mass extending from the S2 vertebra to the coccyx invading the presacral space. Biopsy confirmed the diagnosis of Ewing\'s sarcoma, characterized by the EWS-FLI1 type 1 translocation. A multidisciplinary team comprising neurosurgeons, colorectal surgeons, and plastic surgeons was formulated. En bloc resection of the tumor, lumbopelvic fixation, and soft-tissue reconstruction using bilateral gluteus maximus advancement flaps were successfully performed. The procedure aimed to address both the oncological and functional aspects of the patient\'s condition. Chemotherapy and radiotherapy were administered as adjuvant therapies. At 2-year follow-up, the patient was ambulating independently with no residual tumor on imaging. This case highlights the complex nature of sacral Ewing\'s sarcoma and underscores the importance of a multidisciplinary approach. The described surgical technique, including the innovative use of gluteus maximus advancement flaps for soft-tissue reconstruction, contributes to reducing wound complications and promoting successful patient outcomes. The presented approach serves as a valuable addition to the armamentarium of treatment options for this challenging malignancy.
摘要：
尤因肉瘤是一种罕见且高度侵袭性的骨肿瘤，主要影响儿童和青少年。它通常存在于骨盆和轴向骨骼中，由于其复杂的解剖位置，骶骨受累带来了独特的挑战。这份报告详细介绍了一名18岁男性的骶骨尤因肉瘤，强调诊断，外科,和管理的重建方面。病人出现下背部疼痛,下肢无力,和尿失禁，这促使了广泛的诊断评估。磁共振成像和计算机断层扫描显示，从S2椎骨延伸到尾骨的大量溶解肿块侵犯了s前空间。活检证实了尤因肉瘤的诊断,以EWS-FLI11型易位为特征。由神经外科医生组成的多学科团队，结直肠外科医生,和整形外科医生制定。在肿瘤的整块切除中，腰骨盆固定术,使用双侧臀大肌推进皮瓣成功进行软组织重建。该程序旨在解决患者病情的肿瘤和功能方面。化疗和放疗作为辅助治疗。在2年的随访中，患者独立行走,影像学检查无残留肿瘤.该病例突出了骶骨尤因肉瘤的复杂性，并强调了多学科方法的重要性。所描述的手术技术，包括创新使用臀大肌推进皮瓣进行软组织重建，有助于减少伤口并发症和促进成功的患者预后。所提出的方法是对这种具有挑战性的恶性肿瘤的治疗方案的宝贵补充。
