Ewing's sarcoma

Ewing’s sarcoma is a rare bone tumour which is highly malignant. The condition most frequently occurs in teenagers, and affects males more often than females, with a ratio of 1,5:1. It is found almost exclusively in caucasians. Internationally, the incidence is less than 2 cases per million children.

Ewing’s sarcoma occurs mainly in the femur (thigh bone), pelvis, ribs and humerus (upper arm bone), but any bone may be affected. It is usually situated in the middle of the shaft of a long bone.

Persistant pain and swelling in the affected area are the most common symptoms. Sometimes, a firm lump on the arm or leg can be felt. In physically active children, the pain and swelling of Ewing's sarcoma can sometimes be mistaken for the symptoms of a sport injury.

A diagnosis is made by x-rays and a MRI scan. X-rays show a characteristic "onion skin" appearance. A biopsy is needed to confirm the diagnosis.

Because most patients with apparently localised disease at diagnosis have early metastasis (spreading of cancer cells to other parts of the body, such as the lungs, another bone or the bone marrow), chemotherapy as well as surgery and/or radiation is indicated in the treatment of all patients.

The majority of patients (50-60%) can be cured if treatment starts early and no metastasis has yet occurred. The prognosis and choice of treatment depend on the location, size, and stage of the cancer (how far the cancer has spread), how the cancer cells react to the treatment, and the patient’s age and general health.