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Primary ES of the spine may have a variety of appearances on imaging studies, and can mimic other diseases. A right thoracotomy and wedge resection was performed in a 28 year-old female patient with a pulmonary nodule. Pathological investigation showed this tumor to be Ewing’s sarcoma. This diagnosis led us to perform a radionuclide bone scan and thoracic MR, and on the basis of all findings primary ES of the thoracic spine was diagnosed. Although quite rare, ES should be included in the differential diagnosis of pulmonary nodules.