Muhammad Ahmed Zaman¹, MBBS, Shaikh Saif Ur Rehman², MBBS, Asma Ali Depar³, MBBS, FCPS, Iqra Muhammad Aslam⁴, MBBS, FCPS, Rozilla Sadia Khan⁵, MBBS, MRCOG, FRCOG

¹Department of Gynecology and Obstetrics, Aga Khan University, Stadium Road, ​P. O. Box 350​0 Karachi 7480​0, Pakistan, Karachi, Sindh, Pakistan, Email: ahmedzamannn@gmail.com

²Department of Gynecology and Obstetrics, Aga Khan University, Stadium Road, ​P. O. Box 350​0 Karachi 7480​0, Pakistan, Karachi, Sindh, Pakistan, email: asaifurrehman3@gmail.com

³Department of Gynecology and Obstetrics, Aga Khan University, Stadium Road, ​P. O. Box 350​0 Karachi 7480​0, Pakistan, Karachi, Sindh, Pakistan, email: asma.ali@aku.edu

⁴Department of Gynecology and Obstetrics, Aga Khan University, Stadium Road, ​P. O. Box 350​0 Karachi 7480​0, Pakistan, Karachi, Sindh, Pakistan, Email: iqra.asalam@gmail.com

⁵Department of Gynecology and Obstetrics, Aga Khan University, Stadium Road, ​P. O. Box 350​0 Karachi 7480​0, Pakistan, Karachi, Sindh, Pakistan, Email: rozilla.khan@aku.edu

Corresponding Author: Muhammad Ahmed Zaman, Department of Gastroenterology, Aga Khan University Hospital, Karachi, Pakistan, Email: ahmedzamannn@gmail.com

Citation: Muhammad Ahmed Zaman, Shaikh Saif Ur Rehman, Asma Ali Depar, Iqra Muhammad Aslam, Rozilla Sadia Khan, (2026). Ewing Sarcoma of the Uterine Cervix: A Case Report and Literature Review. American J Case Rep Clin Imag. 2026; May, 4(1), 1-3.

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Highlights:

1. Primary Ewing sarcoma of the uterine cervix is an exceptionally rare malignancy.

2. Large tumor size may predict aggressive behavior despite multimodal therapy.

3. Immunohistochemistry plays a critical role in diagnosing cervical round-cell tumors.

4. Early recurrence and distant metastasis can occur even after complete surgical resection.

5. Multidisciplinary management remains essential in the absence of standardized guidelines.

Abstract:

Ewing sarcoma is a highly aggressive malignant small round-cell tumor that typically arises in bone and is rare in the female genital tract. Primary involvement of the uterine cervix is exceptionally uncommon, with fewer than 30 cases reported in the literature. We report the case of a 37-year-old woman who presented with heavy menstrual bleeding and was found to have a large cervical mass. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy, and histopathological examination with immunohistochemistry supported a diagnosis of extraosseous Ewing sarcoma of the cervix. Initial staging demonstrated no distant metastasis, and she received prolonged multimodal therapy. Despite complete surgical resection and systemic chemotherapy, the patient developed early locoregional recurrence followed by distant hepatic metastases. This case highlights the aggressive clinical behavior of cervical Ewing sarcoma and underscores the diagnostic and therapeutic challenges associated with this rare malignancy.

Keywords: Cervix; Extraosseous Ewing sarcoma; Ewing sarcoma; Gynecologic malignancy; Pelvic mass.