Abstract

Background: Ewing’s sarcoma (ES) is a rare malignant tumor primarily affecting young individuals, with cranial localization being particularly uncommon. While intracranial metastatic ES is infrequent, only four cases of intracranial metastatic ES are reported in the literature; it presents unique diagnostic and therapeutic challenges. Case Description: We present a distinctive case of ES to delineate its clinical, radiological, and histopathological characteristics. Our patient, a 33-year-old, manifested symptoms of intracranial hypertension and gait disturbance. Neurological examination revealed a static and kinetic cerebellar syndrome. Imaging studies and stereotactic biopsy confirmed the diagnosis of primary and metastatic cerebral ES. The treatment regimen encompassed chemotherapy and radiation therapy. Conclusion: Our case underscores the importance of considering ES in the differential diagnosis of dural-based lesions exhibiting cystic components and heterogeneous contrast enhancement, particularly in young individuals. Early recognition and intervention hold promise for optimizing patient outcomes.

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