{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T10:38:44Z","timestamp":1788518324735,"version":"build-2803163510"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T00:00:00Z","timestamp":1771200000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ewing sarcoma (EWS) is a highly aggressive malignant tumor that primarily affects the skeletal system in children and adolescents. Primary pulmonary Ewing sarcoma (PPEWS) is extremely rare, particularly in children, with very few cases reported in the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>This report describes a 10-year-old girl who was admitted with an intermittent cough lasting over 7 months. Chest computed tomography (CT) revealed a mass in the right lower lung lobe. Bronchoscopic biopsy demonstrated a highly malignant undifferentiated small round cell tumor, with immunohistochemistry confirming EWS (positive for CD99, NKX2.2, and FLI-1). After 8 cycles of VDC\/IE neoadjuvant chemotherapy, neoadjuvant therapy enabled tumor conversion from unresectable to resectable status. Postoperative pathology confirmed extraskeletal EWS\/peripheral primitive neuroectodermal tumor (pPNET) following right middle and lower lobectomy, with good postoperative recovery. Following a multidisciplinary team (MDT) consensus, the patient initiated adjuvant chemotherapy utilizing the same VDC\/IE regimen. As of the latest follow-up, she has successfully completed six cycles of adjuvant chemotherapy, and no clinical or radiological signs of recurrence have been observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case underscores the extreme rarity of PPEWS in children and the complexities of its diagnosis and treatment. Neoadjuvant chemotherapy can facilitate tumor conversion, while surgery plays a pivotal role in localized cases with incomplete chemotherapeutic response. Multidisciplinary management is essential for optimizing outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1723340","type":"journal-article","created":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T05:18:56Z","timestamp":1771219136000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Neoadjuvant chemotherapy-enabled tumor conversion and surgical resection in pediatric primary pulmonary Ewing sarcoma: a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Jun-Ping","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong-Rui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian-Bao","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2028910","article-title":"Ewing\u2019s sarcoma","volume":"384","author":"Riggi","year":"2021","journal-title":"New Engl J Med"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1148\/rg.333135005","article-title":"From the radiologic pathology archives: ewing sarcoma family of tumors: radiologic-pathologic correlation","volume":"33","author":"Murphey","year":"2013","journal-title":"RadioGraphics"},{"key":"B3","doi-asserted-by":"publisher","first-page":"152152","DOI":"10.1016\/j.anndiagpath.2023.152152","article-title":"Primary Ewing sarcoma of the lung: A systematic review of the recent literature","volume":"65","author":"Fedeli","year":"2023","journal-title":"Ann Diagn Pathology"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-019-02720-8","article-title":"Ewing sarcoma and Ewing-like tumors","volume":"476","author":"Sbaraglia","year":"2020","journal-title":"Virchows Archiv"},{"key":"B5","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1038\/s41572-018-0003-x","article-title":"Ewing sarcoma","volume":"4","author":"Gr\u00fcnewald","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.59.5256","article-title":"Ewing sarcoma: current management and future approaches through collaboration","volume":"33","author":"Gaspar","year":"2015","journal-title":"J Clin Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2019.07.062","article-title":"Primary bronchial Ewing sarcoma","volume":"61","author":"Mumtaz","year":"2019","journal-title":"Int J Surg Case Rep"},{"key":"B8","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1186\/s13256-024-04749-z","article-title":"Ewing sarcoma presenting in the lung: a case report","volume":"18","author":"Berro","year":"2024","journal-title":"J Med Case Rep"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.14251","article-title":"Primary EWS\/PNET of the lung with TP53 germline and SKT11 somatic mutation: A case report and review of the literature","volume":"13","author":"Zhang","year":"2022","journal-title":"Thorac Cancer"},{"key":"B10","doi-asserted-by":"publisher","first-page":"100296","DOI":"10.1016\/j.opresp.2023.100296","article-title":"Primary pulmonary ewing\u2019s sarcoma: A surprise diagnosis in a 52-year-old active smoker","volume":"6","author":"Jamel","year":"2024","journal-title":"Open Respir Archives"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.21037\/tlcr-22-58","article-title":"Comparative characteristics of small cell lung cancer and Ewing\u2019s sarcoma: a narrative review","volume":"11","author":"Hamilton","year":"2022","journal-title":"Trans Lung Cancer Res"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.23.00053","article-title":"Long-term outcomes in patients with localized ewing sarcoma treated with interval-compressed chemotherapy on children\u2019s oncology group study AEWS0031","volume":"41","author":"Cash","year":"2023","journal-title":"J Clin Oncol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2024.1449119","article-title":"Case report: Pulmonary Ewing sarcoma disguised as non-small cell lung cancer","volume":"14","author":"Carter","year":"2024","journal-title":"Front Oncol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1723340\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T05:18:56Z","timestamp":1771219136000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1723340\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,16]]},"references-count":13,"alternative-id":["10.3389\/fonc.2026.1723340"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1723340","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,16]]},"article-number":"1723340"}}