Ewing Sarcoma of the Sinonasal Tract: A Scoping Review.

Objective: Ewing sarcoma (ES) is a rare aggressive malignancy that can present in the sinonasal region. The objective of this study is to investigate the demographics, presentation, management, and outcomes of patients with sinonasal ES.

Methods: PubMed, Web of Science, SCOPUS, CINAHL, and Cochrane Library. Methods: A scoping review of cases of sinonasal ES was performed. Inclusion criteria consisted of case reports, series, or retrospective reviews.

Results: 785 total articles were retrieved. 72 articles met inclusion criteria and were included in the final review for a total of 93 cases. 48 (53%) patients were male. Mean age at diagnosis was 26.4 years old (range 1-89). Nasal obstruction (N = 55, 59%), epistaxis (N = 35, 38%), and impaired vision (N = 29, 29%) were the most common symptoms. On examination, 38 (41%) patients had a nasal cavity mass. Most tumors (N = 33, 35%) were located in the maxillary sinus. 44 (47%) were left sided and 4 (4%) were bilateral. The most utilized treatment modalities were surgical resection with adjuvant chemoradiotherapy (N = 27, 29%), chemoradiotherapy alone (N = 24, 26%), and surgical resection with adjuvant chemotherapy (N = 14, 15%). 56 patients had no evidence of disease (60%), 14 patients died with disease (15%), and 9 patients were alive with disease (10%) at the time of follow-up.

Conclusions: To our knowledge, we report the first scoping review of sinonasal ES. Patients generally present with non-specific sinonasal symptoms. Surgery with adjuvant chemoradiation is the most common treatment modality for these patients. Methods: NA Laryngoscope, 135:1571-1580, 2025.