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A bstractIntroduction and pur pose. Primary Ewing's sarcoma arising from the bones of the head and neck region is extremely rare representing only 1± 4% of all Ewing's sarcoma cases. Previous reports suggest a better prognosis for that particular anatomic site. The purpose of this study was to analyze the clinico-epidemiologic characteristics of that rare clinical presentation, as well as its patterns of failure and prognosis following treatment. M ater ials and methods. This study included a retrospective review of the medical records of patients with the diagnosis of Ewing's sarcoma of the head and neck region treated at King Faisal Specialist Hospital and Research Center between 1975 and Results . Out of a total number of 24 cases analyzed, there were 17 males and 7 fem ales with a ratio of 2.4:1. The m edian age at diagnosis was 16.5 years. A painful swelling was the m ost comm on clinical presentation. The m axilla was the m ost common site of presentation (9/24 cases). There were 3/24 cases who presented with metastatic disease at diagnosis. The m ajority of patients (16/24 cases) had a tum or size >10 cm . M ost patients were treated with systemic chem otherapy plus localized irradiation following an initial biopsy. W ith a m ean follow up of 3.4 years, the 5-year actuarial overall survival (OS) for the whole group was 53% , while the 5-year actuarial disease-free survival (DFS) was 30% . These ® gures were higher than those reported from our institution for young patients (£ 14 years treated for Ewing' s sarcom a in other anatom ic locations (30 % v 15% ). The response to chem otherapy was the only prognostic factor that affected both the OS and DFS. C onclusio n. The prognosis of Ewing's sarcoma of the head and neck region is slightly better than that of other anatomic sites. The response to systemic chem otherapy is one of the m ost important prognostic factors affecting both DFS and OS of Ewing's sarcoma of the head and neck. M ultimodality therapy consisting of an initial biopsy, aggressive combination chem otherapy and localized radiotherapy is the treatment of choice for Ewing's sarcoma of the head and neck region and m ay result in long-term survival.

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Hyponatraemia is common in patients with cancer. The objectives of this study are to investigate the severity distribution of hyponatraemia and its association with mortality. We retrospectively reviewed medical records for patients admitted to a national centre for cancer care and research in Qatar between 2008 and 2012. A model was built through multivariate analyses to investigate the role of hyponatraemia in mortality. Patients were grouped into those who had moderate-severe hyponatraemia (Na < 130) and those who only had normal-mild hyponatraemia (Na ≥ 130). A total of 2048 patients were included in this study. Prostate (57.1%), pancreatic (50%), liver (49%) and lung (40.2%) cancers showed the highest frequency of moderate-severe hyponatraemia, while breast cancer showed the lowest frequency at 23.5%. In the multivariate analyses, patients with moderate-severe hyponatraemia (Na < 130 mmol/L) were 4.28 times more likely to die than those with normal-mild hyponatraemia (Na ≥ 130) (P < 0.05). The present study shows that hyponatraemia is a common electrolyte disturbance among hospitalised patients with cancer diagnoses. The severity of hyponatraemia was a statistically significant independent factor associated with higher in-hospital mortality. This is in accordance with the reported literature and emphasises the importance of early diagnosis and correction of hyponatraemia.