{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:21:01Z","timestamp":1787772061372,"version":"build-2784847793"},"reference-count":9,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Ewing\u2019s sarcoma is a rare and highly aggressive bone tumor primarily affecting children and adolescents. It commonly presents in the pelvic and axial skeleton, with sacral involvement posing unique challenges due to its intricate anatomical location. This report details the case of an 18-year-old male with sacral Ewing\u2019s sarcoma, emphasizing the diagnostic, surgical, and reconstructive aspects of management. The patient presented with lower back pain, lower limb weakness, and urinary incontinence, which prompted an extensive diagnostic evaluation. Magnetic resonance imaging and computed tomography scans revealed a large lytic mass extending from the S2 vertebra to the coccyx invading the presacral space. Biopsy confirmed the diagnosis of Ewing\u2019s sarcoma, characterized by the EWS-FLI1 type 1 translocation. A multidisciplinary team comprising neurosurgeons, colorectal surgeons, and plastic surgeons was formulated. En bloc resection of the tumor, lumbopelvic fixation, and soft-tissue reconstruction using bilateral gluteus maximus advancement flaps were successfully performed. The procedure aimed to address both the oncological and functional aspects of the patient\u2019s condition. Chemotherapy and radiotherapy were administered as adjuvant therapies. At 2-year follow-up, the patient was ambulating independently with no residual tumor on imaging. This case highlights the complex nature of sacral Ewing\u2019s sarcoma and underscores the importance of a multidisciplinary approach. The described surgical technique, including the innovative use of gluteus maximus advancement flaps for soft-tissue reconstruction, contributes to reducing wound complications and promoting successful patient outcomes. The presented approach serves as a valuable addition to the armamentarium of treatment options for this challenging malignancy.<\/jats:p>","DOI":"10.4103\/jcvjs.jcvjs_162_23","type":"journal-article","created":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T07:00:27Z","timestamp":1710313227000},"page":"110-113","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["En bloc resection followed by gluteal advancement flap for sacral Ewing\u2019s sarcoma: A novel technique"],"prefix":"10.4103","volume":"15","author":[{"given":"Jeena","family":"Joseph","sequence":"first","affiliation":[{"name":"Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edmond","family":"Jonathan","sequence":"additional","affiliation":[{"name":"Department of Neurological Sciences, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark Ranjan","family":"Jesudason","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashish Kumar","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Christian Medical College, Vellore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,13]]},"reference":[{"key":"R1-20240904","doi-asserted-by":"crossref","first-page":"1678","DOI":"10.1002\/ijc.27402","article-title":"The contrasting age-incidence patterns of bone tumours in teenagers and young adults: Implications for aetiology","volume":"131","author":"Arora","year":"2012","journal-title":"Int J Cancer"},{"key":"R2-20240904","doi-asserted-by":"crossref","first-page":"3108","DOI":"10.1200\/JCO.2000.18.17.3108","article-title":"Prognostic factors in Ewing's tumor of bone: Analysis of 975 patients from the European Intergroup Cooperative Ewing's Sarcoma Study Group","volume":"18","author":"Cotterill","year":"2000","journal-title":"J Clin Oncol"},{"key":"R3-20240904","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1007\/s00066-012-0304-z","article-title":"Pelvic Ewing sarcomas. 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Intensity-modulated radiotherapy","volume":"189","author":"Mounessi","year":"2013","journal-title":"Strahlenther Onkol"},{"key":"R4-20240904","doi-asserted-by":"crossref","first-page":"199","DOI":"10.2106\/JBJS.O.00362","article-title":"Improved prognosis for patients with Ewing sarcoma in the sacrum compared with the innominate bones: The Scandinavian Sarcoma Group Experience","volume":"98","author":"Hesla","year":"2016","journal-title":"J Bone Joint Surg Am"},{"key":"R5-20240904","doi-asserted-by":"crossref","DOI":"10.1002\/pbc.26504","article-title":"Pelvis Ewing sarcoma: Local control and survival in the modern era","volume":"64","author":"Ahmed","year":"2017","journal-title":"Pediatr Blood Cancer"},{"key":"R6-20240904","doi-asserted-by":"crossref","first-page":"571","DOI":"10.3171\/2014.10.SPINE14114","article-title":"Soft-tissue reconstruction after total en bloc sacrectomy","volume":"22","author":"Kim","year":"2015","journal-title":"J Neurosurg Spine"},{"key":"R7-20240904","doi-asserted-by":"crossref","first-page":"1013","DOI":"10.1097\/00006534-200003000-00026","article-title":"Gluteus maximus adipomuscular turnover or sliding flap in the surgical treatment of extensive sacral chordomas","volume":"105","author":"Furukawa","year":"2000","journal-title":"Plast Reconstr Surg"},{"key":"R8-20240904","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1097\/01.SAP.0000054241.94281.D2","article-title":"Interdigitating fasciocutaneous gluteal V-Y advancement flaps for reconstruction of sacral defects","volume":"50","author":"Ay","year":"2003","journal-title":"Ann Plast Surg"},{"key":"R9-20240904","doi-asserted-by":"crossref","first-page":"526","DOI":"10.1097\/01.sap.0000205772.15061.39","article-title":"Reconstruction of extensive partial or total sacrectomy defects with a transabdominal vertical rectus abdominis myocutaneous flap","volume":"56","author":"Glatt","year":"2006","journal-title":"Ann Plast Surg"}],"container-title":["Journal of Craniovertebral Junction and Spine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_162_23","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:26:57Z","timestamp":1787768817000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jcvjs.jcvjs_162_23"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1]]},"references-count":9,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024]]}},"URL":"https:\/\/doi.org\/10.4103\/jcvjs.jcvjs_162_23","relation":{},"ISSN":["0974-8237","0976-9285"],"issn-type":[{"value":"0974-8237","type":"print"},{"value":"0976-9285","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1]]},"assertion":[{"value":"2023-11-19","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-12-31","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}