Ewing sarcoma is most common in adolescents and young adults.
Ewing sarcoma has also been called peripheral primitive neuroectodermal tumor, Askin tumor (Ewing sarcoma of the chest wall), extraosseous
Ewing sarcoma (Ewing sarcoma in tissue other than bone), and Ewing sarcoma family of tumors.
Signs and symptoms of Ewing sarcoma include swelling and pain near the tumor.
These and other signs
may be caused by Ewing sarcoma or by other conditions.
Check with your child’s doctor if your child has any of the following:
Pain and/or swelling, usually in the arms, legs, chest, back, or pelvis.
A lump (which may feel soft and warm) in the arms, legs, chest, or pelvis.
Tests that examine the bone and soft tissue are used to diagnose and stage Ewing sarcoma.
Procedures that make pictures of the bones and soft tissues and nearby areas help diagnose
Ewing sarcoma and show how far the cancer
has spread. The process used to find out if cancer cells have spread within and around the bones and soft tissues is called staging.
In order to plan treatment, it is important to know if the cancer is in the area where it first formed or if it has spread to other parts of the body. Tests and procedures to detect, diagnose, and stage
Ewing sarcoma are usually done at the same time.
The following tests and procedures may be used to diagnose or stage Ewing sarcoma:
and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
(magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the area where the tumor formed. This procedure is also called nuclear magnetic resonance imaging (NMRI).
(CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the area where the tumor formed or the chest, taken from different angles. The pictures are made by a computer linked to an x-ray
machine. A dye
may be injected
into a vein
or swallowed to help the organs
or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
(positron emission tomography scan): A procedure to find malignant
tumor cells in the body. A small amount of radioactiveglucose
(sugar) is injected into a vein. The PET scanner
rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
A PET scan and a CT scan are often done at the same time. If there is any cancer, this increases the chance that it will be found.
Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.
The portion of the blood sample made up of red blood cells.
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances, such as lactate dehydrogenase
(LDH), released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
A biopsy is done to diagnose Ewing sarcoma.
Tissue samples are removed during a biopsy so they can be viewed under a microscope by a pathologist to check for signs of cancer. It is helpful if the biopsy is done at the same center where treatment will be given.
Needle biopsy: For a needle biopsy, tissue is removed using a needle. This type of needle biopsy may be done if it’s possible to remove tissue samples large enough to be used for testing.
Excisional biopsy: The removal of an entire lump or area of tissue that doesn’t look normal.
(pathologist, radiation oncologist, and surgeon) who will treat the patient usually work together to decide where the needle should be placed or the biopsy incision should be made. This is done so that the biopsy doesn't affect later treatment such as surgery
to remove the tumor or radiation therapy.
If there is a chance that the cancer has spread to nearby lymph nodes, one or more lymph nodes may be removed and checked for signs of cancer.
The following tests may be done on the tissue that is removed:
Immunohistochemistry: A test that uses antibodies
to check for certain antigens
in a sample of tissue. The antibody is usually linked to a radioactive substance or a dye that causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer.
Flow cytometry: A laboratory test that measures the number of cells in a sample, the percentage of live cells in a sample, and certain characteristics of cells, such as size, shape, and the presence of tumor markers
on the cell surface. The cells are stained with a light-sensitive dye, placed in a fluid, and passed in a stream before a laser
or other type of light. The measurements are based on how the light-sensitive dye reacts to the light.
Certain factors affect prognosis (chance of recovery).
The factors that affect prognosis
(chance of recovery) are different before and after treatment.
Before treatment, prognosis depends on:
Whether the tumor has spread to lymph nodes or distant parts of the body.
Where in the body the tumor started.
Whether the tumor formed in the bone or in soft tissue.
How large the tumor is at when the tumor is diagnosed.
Whether the LDH level in the blood is higher than normal.