Abstract
Ewing sarcoma (ES) is a high-grade osseous malignancy that typically occurs between 10 and 20 years of age. Prognosis is poor with a 30% five-year survival in the case of metastatic disease. This case describes a 20-year-old female patient with known lumbar vertebral ES developing a splenic metastasis years after primary treatment. To the best of our knowledge, metastatic spread to the spleen in ES has not been reported before. Teaching point: In patients with a history of Ewing sarcoma, new parenchymal lesions should always prompt consideration of rare metastatic disease, given its profound prognostic impact.