{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T06:15:11Z","timestamp":1788156911094,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Ewing sarcoma (ES) is an aggressive tumor of the bone in young adults, commonly originating from the pelvis and long bones. It is characterized by chromosomal translocation t(11;22) (q24;q12), resulting in the EWSR1\u2010FLI1 fusion gene. It presents with metastasis commonly to the lungs and other soft tissues. While the metastasis to lungs is common, orbital involvement with cranial involvement is exceptionally rare. The case highlights the need for the early detection and aggressive treatment in order to reduce mortality in patients ES. A 23\u2010year\u2010old South\u2010Asian male presented with a 2\u2009month history of progressive shortness of breath, 10\u2009\u00d7\u200915\u2009cm swelling on the left side of chest, and left\u2010sided proptosis with diplopia. The early examination of the patient showed left\u2010sided pleural effusion and ophthalmoplegia involving cranial nerves II, III, IV, VI, and V1. Computed Tomography (CT) identified a rib\u2010origin mass extending into the pleura, and Magnetic Resonance Imaging (MRI) confirmed an orbital mass compressing the optic nerve. Pleural fluid analysis showed an exudative, lymphocyte\u2010predominant picture with elevated Adenosine Deaminase (ADA), initially mimicking tuberculosis. However, a CT\u2010guided biopsy of the chest mass confirmed small round blue cell histology. Immunohistochemistry (IHC) was positive for CD99 and NKX2.2 with a high Ki\u201067 index, confirming Ewing sarcoma. The patient was initiated on multimodal chemotherapy but succumbed to rapid disease progression and respiratory failure 2\u2009months post\u2010diagnosis. ES is a highly aggressive bone tumor. Early diagnosis with subsequent aggressive treatment particularly is very important for the survival of the patient. Immunohistochemistry can be helpful in the diagnosis of the tumor, especially in resource\u2010limited countries. Timely intervention is important in Ewing sarcoma owing to the risk of metastasis. Radiation, chemotherapy, and surgical interventions can be used depending upon the patient's prognosis.<\/jats:p>","DOI":"10.1002\/ccr3.72309","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T05:25:51Z","timestamp":1773638751000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Rib\u2010Origin Ewing Sarcoma With Cranial Nerve Involvement From Orbital Metastasis: A Rare Case Report"],"prefix":"10.1002","volume":"14","author":[{"given":"Muhammad Noraiz Abbas","family":"Khan","sequence":"first","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khubaib","family":"Ghufran","sequence":"additional","affiliation":[{"name":"Institute of T.B. And Chest Medicine, Mayo Hospital  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Tausif","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inbsaat","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy and Medical Oncology Mayo Hospital  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wardah","family":"Malik","sequence":"additional","affiliation":[{"name":"Department of Pathology King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Usman","family":"Iqbal","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5542-4497","authenticated-orcid":false,"given":"Fatima","family":"Hajj","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Lebanese University  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djq278"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572\u2010018\u20100003\u2010x"},{"key":"e_1_2_10_4_1","unstructured":"Identification of Discrete Prognostic Groups in Ewing Sarcoma \u2010 PubMed accessed August 16 2025 https:\/\/pubmed.ncbi.nlm.nih.gov\/26257296\/."},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020890"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22456"},{"issue":"2","key":"e_1_2_10_7_1","first-page":"111","article-title":"Ewing Sarcoma of Orbit With Intracranial Extension","volume":"31","author":"Abbasi S.","year":"2015","journal-title":"Pakistan Journal of Ophthalmology"},{"issue":"11","key":"e_1_2_10_8_1","article-title":"Ewing's Sarcoma of the Orbit: A Case Report and Literature Review","volume":"15","author":"Das J.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sycrs.2024.100027"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428\u2010014\u20101627\u20101"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.5256"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.70.6226"},{"issue":"1","key":"e_1_2_10_13_1","first-page":"30","article-title":"Primary and Metastatic Ewing Sarcoma of the Skull Base \u2013 Case Reports and Comparative Analysis","volume":"77","author":"Cherekaev V. A.","year":"2013","journal-title":"Zhurnal Voprosy Ne\u012drokhirurgii Imeni N. N. Burdenko"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCO.0b013e328303ba1d"}],"updated-by":[{"DOI":"10.1002\/ccr3.73410","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000}}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72309","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.72309","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.72309","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T06:08:25Z","timestamp":1774505305000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.72309"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3]]},"references-count":13,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/ccr3.72309"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.72309","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3]]},"assertion":[{"value":"2025-10-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e72309"}}