Ewing sarcoma
Bone cancer - Ewing sarcoma; Ewing family of tumors; Primitive neuroectodermal tumors (PNET); Bone neoplasm - Ewing sarcoma; Ewing's sarcomaEwing sarcoma is a malignant bone tumor that forms in the bone or soft tissue around it. It affects mostly teens and young adults.
Bone tumor
A bone tumor is an abnormal growth of cells within a bone. A bone tumor may be cancerous (malignant) or noncancerous (benign).
Causes
Ewing sarcoma can occur anytime during childhood and young adulthood. But it usually develops during puberty, when bones are growing rapidly. It is more common in White children than in Black or Asian children.
The tumor may start anywhere in the body. Most often, it starts in the long bones of the arms and legs, the pelvis, or the chest. It can also develop in the skull or the flat bones of the trunk.
Long bones
Long bones are hard, dense bones that provide strength, structure, and mobility. The thigh bone (femur) is a long bone. A long bone has a shaft and...
Flat bones
Flat bones are made up of a layer of spongy bone between two thin layers of compact bone. They have a flat shape, not rounded. Examples include the...
The tumor often spreads (metastasizes) to the lungs and other bones. At the time of diagnosis, spread is seen in about one third of children with Ewing sarcoma.
Metastasizes)
Metastasis is the movement or spreading of cancer cells from one organ or tissue to another. Cancer cells usually spread through the blood or the ly...
In rare cases, Ewing sarcoma occurs in adults.
Symptoms
There are few symptoms. The most common is pain and sometimes swelling at the site of the tumor.
Because the tumor weakens the bone, children may also break a bone at the site of the tumor after a minor injury.
Fever may also be present.
Exams and Tests
If a tumor is suspected, tests to locate the primary tumor and any spread (metastasis) often include:
- Bone scan
Bone scan
A bone scan is an imaging test used to diagnose bone diseases and find out how severe they are.
ImageRead Article Now Book Mark Article - Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
ImageRead Article Now Book Mark Article - CT scan of the chest
CT scan of the chest
A chest CT (computed tomography) scan is an imaging method that uses x-rays to create cross-sectional pictures of the chest and upper abdomen....
ImageRead Article Now Book Mark Article - MRI of the tumor
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
ImageRead Article Now Book Mark Article - X-ray of the tumor
A biopsy of the tumor will be done. Different tests are done on this tissue to help determine how aggressive the cancer is and what treatment may be best.
Biopsy
A bone lesion biopsy is the removal of a piece of bone or bone marrow for examination.
Treatment
Treatment often includes a combination of:
- Chemotherapy
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
ImageRead Article Now Book Mark Article - Radiation therapy
Radiation therapy
Radiation therapy uses high-powered radiation (such as x-rays or gamma rays), particles, or radioactive seeds to kill cancer cells.
ImageRead Article Now Book Mark Article - Surgery to remove the primary tumor
Surgery
Surgical excision is the removal of tissue using a sharp knife (scalpel) or other cutting instrument.
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Treatment depends on the following:
- Stage of the cancer
Stage
Cancer staging is a way to describe how much cancer is in your body and where it is located. Staging helps determine where the original tumor is, ho...
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- Results of the tests on the biopsy sample
Support Groups
The stress of illness can be eased by joining a cancer support group. Sharing with others who have common experiences and problems can help you not feel alone.
Cancer support group
The following organizations are good resources for information on cancer:American Cancer Society. Support and online communities. www. cancer. org/...
Outlook (Prognosis)
Before treatment, outlook depends on:
- Whether the tumor has spread to distant parts of the body
- Where in the body the tumor started
- How large the tumor is when it's diagnosed
- Whether the lactate dehydrogenase (LDH) level in the blood is higher than normal
Lactate dehydrogenase
The lactate dehydrogenase (LDH) isoenzyme test checks how much of the different types of LDH, called isoenzymes, are present in the blood.
ImageRead Article Now Book Mark Article - Whether the tumor has certain gene changes
- Whether the child is younger than 15 years
- Child's sex
- Whether the child has had treatment for a different cancer before Ewing sarcoma
- Whether the tumor has just been diagnosed or has come back
The best chance for cure is with a combination of treatments that includes chemotherapy plus radiation or surgery.
Possible Complications
The treatments needed to fight this disease may have many complications. Discuss these with your health care provider.
When to Contact a Medical Professional
Contact your provider if your child has any of the symptoms of Ewing sarcoma. An early diagnosis can increase the possibility of a favorable outcome.
References
Heck RK, Toy PC. Malignant tumors of bone. In: Azar FM, Beaty JH, eds. Campbell's Operative Orthopaedics. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 27.
National Cancer Institute website. Ewing sarcoma and undifferentiated small round cell sarcomas of bone and soft tissue treatment (PDQ) - health professional version. www.cancer.gov/types/bone/hp/ewing-treatment-pdq. Updated April 19, 2024. Accessed May 15, 2024.
National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): Bone cancer. Version 2.2024. www.nccn.org/professionals/physician_gls/pdf/bone.pdf. Updated March 12, 2024. Accessed May 15, 2024.
X-ray - illustration
X-rays are a form of ionizing radiation that can penetrate the body to form an image on film. Structures that are dense (such as bone) will appear white, air will be black, and other structures will be shades of gray depending on density. X-rays can provide information about obstructions, tumors, and other diseases, especially when coupled with the use of barium and air contrast within the bowel.
X-ray
illustration
Ewing sarcoma - X-ray - illustration
This X-ray shows a malignant bone tumor (Ewing sarcoma) of the upper arm bone (humerus). This type of tumor usually occurs during childhood and adolescence.
Ewing sarcoma - X-ray
illustration
X-ray - illustration
X-rays are a form of ionizing radiation that can penetrate the body to form an image on film. Structures that are dense (such as bone) will appear white, air will be black, and other structures will be shades of gray depending on density. X-rays can provide information about obstructions, tumors, and other diseases, especially when coupled with the use of barium and air contrast within the bowel.
X-ray
illustration
Ewing sarcoma - X-ray - illustration
This X-ray shows a malignant bone tumor (Ewing sarcoma) of the upper arm bone (humerus). This type of tumor usually occurs during childhood and adolescence.
Ewing sarcoma - X-ray
illustration
Review Date: 3/31/2024
Reviewed By: Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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