Extraskeletal Ewing sarcoma is a rare and aggressive tumor, often presenting diagnostic challenges because of its nonspecific radiologic and clinical features. This case report highlights a unique instance of a primary extraskeletal spinal Ewing sarcoma (PESES), initially misdiagnosed as a neurogenic tumor. The report discusses the imaging characteristics that led to the initial misdiagnosis and reviews the distinguishing features of PESES on advanced imaging modalities. This case emphasizes the necessity of a comprehensive diagnostic approach for an accurate diagnosis of PESES, including a high degree of suspicion, advanced imaging techniques, and histopathological correlation.

Extraskeletal Ewing sarcoma is a rare and aggressive tumor, often presenting diagnostic challenges because of its nonspecific radiologic and clinical features. This case report highlights a unique instance of a primary extraskeletal spinal Ewing sarcoma (PESES), initially misdiagnosed as a neurogenic tumor. The report discusses the imaging characteristics that led to the initial misdiagnosis and reviews the distinguishing features of PESES on advanced imaging modalities. This case emphasizes the necessity of a comprehensive diagnostic approach for an accurate diagnosis of PESES, including a high degree of suspicion, advanced imaging techniques, and histopathological correlation.

Extraskeletal Ewing sarcoma is a rare and aggressive tumor, often presenting diagnostic challenges because of its nonspecific radiologic and clinical features. This case report highlights a unique instance of a primary extraskeletal spinal Ewing sarcoma (PESES), initially misdiagnosed as a neurogenic tumor. The report discusses the imaging characteristics that led to the initial misdiagnosis and reviews the distinguishing features of PESES on advanced imaging modalities. This case emphasizes the necessity of a comprehensive diagnostic approach for an accurate diagnosis of PESES, including a high degree of suspicion, advanced imaging techniques, and histopathological correlation.

Extraskeletal Ewing sarcoma is a rare and aggressive tumor, often presenting diagnostic challenges because of its nonspecific radiologic and clinical features. This case report highlights a unique instance of a primary extraskeletal spinal Ewing sarcoma (PESES), initially misdiagnosed as a neurogenic tumor. The report discusses the imaging characteristics that led to the initial misdiagnosis and reviews the distinguishing features of PESES on advanced imaging modalities. This case emphasizes the necessity of a comprehensive diagnostic approach for an accurate diagnosis of PESES, including a high degree of suspicion, advanced imaging techniques, and histopathological correlation.