Abstract
Ewing's sarcoma is an aggressive small round cell tumor and represents the second most common malignant bone neoplasm in children, following osteosarcoma. However, spinal Ewing's sarcoma is a rare entity in children, with extra-vertebral locations being more common. This case is distinguished by several particularities: atypical initial symptoms, and a diagnostic delay possibly related to either underestimation by the family or false reassurance from an initially unremarkable standard radiograph; unusual vertebral involvement; and a cervical location, which is even more exceptional. Moreover, there is an overlap in radiological and histological presentations with other tumor types, highlighting the importance of multidisciplinary correlation (clinical, radiological, and histopathological) to establish an accurate diagnosis. The patient underwent surgical decompression followed by chemotherapy. Disease progression was subsequently observed on follow-up imaging.