Ewings sarcoma of the zygoma reconstructed with a gold prosthesis: a rare tumor and unique reconstruction

Abstract

Ewings sarcoma (ES) is a rare tumor, most commonly encountered within the long bones during the first 20 years of life. We report the sixth case of ES of the zygoma, occurring in a 31-year-old male, and presenting a unique reconstructive opportunity. Diagnosis and preoperative planning were aided by CT/MR coregistration. Surgical reconstruction using 3D reconstructed CT images to produce an anatomically correct model provided the basis for a gold prosthesis construction. Delayed definitive reconstruction provided opportunity for adequate tumor recurrence surveillance, and definitive histological diagnosis. The artefact produced on MR imaging from gold implants is minimal, permitting the unrestricted identification of potential future recurrence. This case highlights the benefits of coregistration of radiological imaging, and custom-made gold prostheses providing the advantage of artefact-free MR imaging, which should be considered in patients requiring resection of zygomatic tumors and subsequent reconstruction.