Diagnostic and treatment of Ewing sarcoma
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Medias Cancer Clinic Burghausen
Department of Oncology and Surgical Oncology
Memorial Sisli Hospital Istanbul
Department of Oncology
Memorial Bahcelievler Hospital Istanbul
Department of Oncology and Radiation Oncology
University Hospital Ulm
Department of Hematology, Oncology, Palliative Care, Rheumatology and Infectology
Rambam Health Care Campus Haifa
Department of Oncology
Medicana International Istanbul Hospital
Department of Oncology
Samsung Medical Center Seoul
Department of Oncology and Hematology
University Hospital Freiburg
Department of Hematology and Oncology
University Hospital Frankfurt am Main
Cancer Center
University Hospital Heidelberg
Department of Hematology, Oncology, Adult and Pediatric Rheumatology
University Hospital Würzburg
Department of Gastroenterology, Hematology, Oncology, Hepatology, Infectology, Rheumatology and Clinical Immunology
University Hospital RWTH Aachen
Department of Oncology and Hematology
University Hospital Carl Gustav Carus Dresden
Department of Oncology
University Hospital Erlangen
Department of Hematology and Oncology
University Hospital Halle (Saale)
Department of Hematology and Oncology
Ewing’s sarcoma is a cancerous tumor that affects the bones and their surrounding tissue. Predominantly affecting young adolescents, aged 15-20, Ewing’s sarcoma develops in cartilage, thigh bones, tissue or certain nerve endings. 87% of all cases develop in the bones. According to WebMD, Ewing’s sarcoma is a very rare condition, affecting approximately 200 adolescents in the USA each year. It is believed to be more common in males and it mostly affects Caucasians. Although Ewing’s sarcoma is rare, it has good survival rates. Approximately 70% of children and teenagers diagnosed with Ewing’s sarcoma make a full recovery from this disease.
There is a theory that Ewing’s sarcoma can be caused by changes in DNA coding, which appear immediately after birth but only manifest themselves 15 to 20 years later. However, it has been proven that Ewing’s sarcoma is not an inherited genetic disorder that runs in families. Rather, this disease is generally believed to be caused by environmental factors that can cause adverse side effects over time, such as exposure to radiation and radical chemicals. In very rare cases, Ewing’s sarcoma can appear as a secondary cancer in people who have undergone several courses of radiation therapy.
- Pain in the bones
- Swelling
- Fatigue
- Weight loss
- A lump that does not disappear after a few weeks
- Stiffness
- Irritability
- Slight fever
- An X-ray can be performed to investigate the area of the patient’s body where a tumor is suspected to be located. The image can help doctors to determine whether there are any abnormalities in the patient’s bone structure.
- A bone scan is also a very effective way to make a diagnosis. Radioiodine dye is injected into the patient’s vein. If the radioiodine dye accumulates in one place, this identifies the presence of a tumor. If the dye is scattered, it indicates that the patient does not have a bone tumor and the pain and lump must be caused by something else.
- MRI and CT scans are performed once the approximate location of the tumor has been determined. These scans are able to detect how much the lump has grown.
- A biopsy of bone tissue is examined under the microscope to look for the presence of malignant cells.
- Chemotherapy and radiation therapy kills as many malignant cells as possible. Chemotherapy drugs are usually injected into the vein to get them into the bloodstream quickly. Radiation therapy shrinks the tumor and stops it from spreading. If the tumor is localized, chances for a full recovery are as high as 80%, which is encouraging.
- Surgery is performed if the exact location of the tumor has been determined and if it can be resected. If Ewing’s sarcoma has metastasized to the lymph nodes or other accessible parts of the body, surgical intervention may also be necessary. However, surgical procedures are not often used in the initial stages of Ewing’s sarcoma.
Authors: Dr. Nadezhda Ivanisova, Dr. Farrukh Ahmed