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This case highlights the importance of a diligent and systematic approach to diagnose PNS. A relentless search is often required to detect PNS-associated occult malignancies.Ewing's sarcoma is a rare and aggressive tumor that typically arises in the long bones of the extremities. It belongs in the family of small round blue cell tumors and is characterized immunohistochemically by diffuse CD99 expression and molecularly by one of several oncogenic translocations, most commonly t(11;22)(q24;q12) between the EWSR1 gene and the FLI1 gene. H
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