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Introduction and importance: Ewing sarcoma (ES) is a malignant tumour prevalent in young adults with a reported 5-year survival ranging between 40 and 60% in most studies. Majority of the patients with ES are usually diagnosed late with significant chest wall mass, chest pain or respiratory distress. Case presentation: Here, the authors present a case of a 21-year-old female with a diagnosis of right sided chest wall ES treated with neoadjuvant chemotherapy followed by surgical resection of the mass. Clinical findings and investigations: The patient presented to the Surgical OPD with shortness of breath for 6 months associated with chest pain on the right side. Radiological investigations including chest X-ray and multi-detector row computed tomography chest was done. Additionally, diagnosis of ES was confirmed with histopathological examination of the mass obtained from fine needle aspiration cytology. Interventions and outcome: She was planned for safe maximal resection of tumour with chest wall reconstruction using double prolene mesh with bone cement and the defect was sutured with adjacent ribs. Good outcome was noted on postoperative period with resolution of symptoms. Relevance and impact: This procedure is now commonly used and is considered as an effective treatment for chest wall tumours, which was also noted in our case and the procedure is also well tolerated.

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Different treatment options are available for subclavian stenosis (SS). Carotid to subclavian bypass surgery (CSBS) is an increasingly used effective treatment strategy when stenting is impossible. However, in Nepal, little is known about SS and its management. A 58-year-old man with a history of aortic valve replacement surgery complained of progressive left arm weakness for the past 6 months associated with pain on exertion and blood pressure discrepancies in both arms. A computed tomographic scan confirmed near-complete subclavian artery stenosis and a Doppler ultrasound showed decreased blood flow and systolic velocity. CSBS was selected as stenting was not feasible. Post-CSBS, all hemodynamic parameters returned to normal, lasting even after 2 years. CSBS appears to be a viable, safe, and promising treatment for symptomatic SS. However, additional studies need to be conducted to analyze the benefits of CSBS relative to other interventions.