A Rare Case Report of Ewing Sarcoma Right Proximal Phalanx of Big Toe

Introduction: Ewing’s sarcoma localized to foot is extremely rare. Local control is mandatory because of the aggressive nature of the tumor. Therapeutic options for these local tumors include neoadjuvant chemotherapy followed by surgery. Case Presentation: A 16-year-old male patient presented with 8-month history of progressive swelling and intermittent pain of the right great toe. Plain radiography and magnetic resonance imaging revealed an expansile mass that had originated from the proximal phalanx of the great toe and was destructing and surrounding the distal phalanx. Distant metastasis was noted in the T 12 vertebra. The patient underwent a closed biopsy, which confirmed the diagnosis of Ewing’s sarcoma. He was treated with neoadjuvant chemotherapy and radiotherapy. Surgical excision of tumor was advised but patient party was not willing for surgical management. Conclusion: The distal phalanx of the foot is an extremely rare site for the development of Ewing’s sarcoma. As local control is important to avoid dissemination of the disease, neoadjuvant chemotherapy followed by amputation or disarticulation of the affected digit and subsequently adjuvant chemotherapy may be favorable modality for increasing the patient’s duration of survival.