Abstract
Ewing's sarcoma is the second most common malignant bone tumor in children, with the worst outcomes seen in patients over the age of 20. However, the onset of the disease is much less common in people over the age of 30. This case represents the diagnostic dilemma posed by an otherwise "straight forward" case of back pain. Keeping the differential diagnosis sufficiently broad to include bone malignancies, so as not to delay diagnosis and treatment, provides the best chance at a positive outcome.