Introduction
Our world-renowned orthopedic surgeons and orthopedists are experts in their fields with specialized training to provide the optimal diagnosis and treatment for a range of orthopedic conditions. We are internationally recognized for delivering the highest-quality orthopedic care to our patients.
What is Ewing sarcoma?
Ewing sarcoma is a rare form of bone cancer, making up only one percent of pediatric cancers and developing in only a few hundred patients per year in the United States. While primarily a bone tumor, it can infrequently arise in soft tissue as well. It is most common in children and young adults, but it can occur in adults too. It frequently begins in long bones of the leg, such as the femur, tibia or humerus, or in the pelvis, but it can also develop in flat bones such as the ribs and clavicle.
What causes it?
Several specific genetic mutations have been linked to Ewing sarcoma. While these tumors occur more frequently during active growth periods such as during a child’s adolescent years, it is unclear why this specific mutation develops. There is no evidence that environmental, social, dietary or other external factors contribute to its development. It is more common in patients of European descent and less common in those of African descent.
What are the symptoms?
Symptoms include a painful swollen area, which may be more visible if on a limb. If located on the pelvis or spine, it may be harder to see, and pain may be the main symptom. Patients may feel uncomfortable even while sitting or resting. They may experience pain that wakes them from sleep and makes them feel stiff or weak or limits range of motion.
How is it diagnosed?
Ewing sarcoma is diagnosed using imaging studies, such as an X-ray or MRI. A CT scan of the chest and either a PET scan or bone scan is often used as well to detect the extent of the disease. Ultimately, a biopsy is required to sample the tumor and review its microscopic appearance. A bone marrow biopsy is often also performed.
How is it treated?
Ewing sarcoma requires a comprehensive team approach, including the multidisciplinary expertise of orthopedic oncologists, pediatric oncologists, medical oncologists, radiation oncologists, musculoskeletal radiologists, bone and soft tissue pathologists, nuclear medicine specialists, surgical oncologists and plastic and reconstructive surgeons, among others.
Treatment includes both systemic chemotherapy and controlling the site of the tumor using surgery and/or radiation. After a few months of chemotherapy, the tumor is removed surgically or with radiation. Thereafter, additional chemotherapy is administered. Treatment generally spans nine to 10 months.
What happens following treatment?
Patients treated for Ewing sarcoma require close monitoring for a period of five years. This includes physical examinations and periodic imaging studies. Many patients continue to follow up even after five years, though at a reduced frequency.
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