Compressive optic neuropathy secondary to Ewing sarcoma in the paranasal sinus A case report

Abstract

Rationale: Ewing sarcoma localized in the paranasal sinuses, compressing the optic nerve, is very rare, with no prior case reportsPatient concerns: A 68-year-old woman presented with decreased visual acuity in her left eye and paresthesia of the left face. Brain magnetic resonance imaging showed heterogeneously enhancing mass in the left paranasal sinuses with adjacent bone destruction, extending to the extraocular muscles and optic nerve of the left orbit. A biopsy of the nasal cavity confirmed Ewing sarcoma.Diagnosis: Compressive optic neuropathy secondary to Ewing sarcoma in the paranasal sinuses.Intervention: Neoadjuvant chemotherapy and radiotherapy were performed.Outcomes: Resolution of the tumor and increased visual acuity and field of the left eye.Lessons: Primary head and neck Ewing sarcoma can lead to compressive optic neuropathy, but the tumor responded well to the chemotherapy. Early diagnosis and immediate treatment by close cooperation between the ophthalmologist and oncologist can prevent from permanent visual loss.