A 28-year-old man was referred after unplanned excision of an infrapatellar 4-cm nodule. The pathologic diagnosis was extraskeletal Ewing's sarcoma. After neo-adjuvant chemotherapy and radiotherapy, re-excision and reconstruction with BPTB allograft and ALT flap were performed, similar to patients 1 and 2. Post-operative management was similar to the previous 2 cases, with the reduced period of the knee brace maintained in straight of 6 weeks. Post-operative course was uneventful. Bone union was completed 1 year after surgery. At 30 months after surgery, the patient was continuously free of disease. The bone-bone junctions were united, and his knee function was satisfactory, with minor knee extension lag (<5 ), knee flexion of 135 , full muscle strength and MSTS score of 30/30.