Ewing's Sarcoma

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Ewing's sarcoma - tibia

Ewing's sarcoma (EWS) belongs to the sarcomas of the Ewing group: EWS, PNET (primitive neuroectodermal tumor), Askin's tumor (Ewing on the chest wall).

It is the 2nd most common malignant bone tumor in children and adolescents, the highest incidence between 5–30 years of age. Early metastasis to the lungs is typical.

It most often develops in the bone marrow of the diaphysis of long bones (mainly femur, tibia). It often mimics acute osteomyelitis: subfebrile, leukocytosis, increased sedimentation, pain, including positive scintigraphy.

Clinical picture: Pain, swelling, pathological fractures

RTG: osteolytic changes with permeative bone destruction + periosteal reaction.

Therapy: 1. neoadjuvant CHT , 2. radical surgical resection, 3. intraoperative / subsequent RT , 4. adjuvant CHT.

Cells of Ewing's sarcoma

Prognosis: 5-year survival 60-76% (in case of no metastases).

References

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Literature

• SOSNA, A., P. VAVŘÍK a M. KRBEC, et al. Základy ortopedie. 1st edition. Prague: Triton, 2001. ISBN 80-7254-202-8.
• DUNGL, P., et al. Orthopedics. 1st edition. Prague: Grada Publishing, 2005. ISBN 80-247-0550-8.
• GALLO, Jiří, et al. rthopedics for students of medical and health faculties 1st edition. Olomouc: Palacký University in Olomouc, 2011. ISBN 978-80-244-2486-6.