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Health Information Center

Ewing Sarcoma

  • Michael Jubinville, MPH
Publication Type:


Ewing Sarcoma

(Peripheral Primitive Neuroectodermal Tumors [PNET]; Ewing Family of Tumors)


Ewing sarcoma is a type of bone cancer. The most commonly affected areas include the pelvis, thigh, lower leg, upper arm, and chest wall.

Leg and Pelvic Bones—Common Sarcoma Sites.

Leg boneshttp://services.epnet.com/getimage.aspx?imageiid=68706870leg_bones_male.jpgLeg bonesNULLjpgLeg bonesNULL\\hgfiler01a\intellect\images\leg_bones_male.jpgNULL41NULL2008-01-283961406870_227284Copyright © Nucleus Medical Media, Inc.


Cancer is when cells in the body split without control or order. These cells go on to form a growth or tumor. The term cancer refers to harmful growths. These growths attack nearby tissues and can also spread to other parts of the body.

It is not exactly clear what causes Ewing sarcoma. It is likely a mix of genes and the environment.

Risk Factors

Ewing sarcomas are more common in males and people who are white. They are also more common older children and teens but can happen at any age.


Symptoms will depend on where the tumor is. They may include:

  • Pain that:
    • May come and go or be constant
    • Ranges from mild to severe
    • May include a feeling of pins and needles
  • Redness and swelling around the area
  • Tiredness
  • Fever
  • Weight loss and loss of hunger
  • Broken bone with no known cause


The doctor will ask about symptoms and past health. A physical exam will also be done. Many bone issues cause the same symptoms. Tests will help to confirm Ewing sarcoma.

The doctor will do a biopsy. A sample of tissue will be removed from the area. A lab will look for cancer cells.

Bone Biopsy.

Bone biopsyhttp://services.epnet.com/getimage.aspx?imageiid=75837583si55551140.jpgsi55551140.jpgNULLjpgsi55551140.jpgNULL\\hgfiler01a\intellect\images\si55551140.jpgNULL42NULL2008-12-10261400Copyright © Nucleus Medical Media, Inc.

Image tests will show the size and location of the tumor. Tests may include:

The doctor may also order blood tests. It will help to show if bone tissue was damaged.

Tests also help find out if the cancer is local or spread to distant parts of the body. This is called staging.


The goal of treatment is to remove or kill as much of the cancer as possible. Treatment will be based on tumor size and location. It often includes a mix of treatments such as:

  • Chemotherapy (chemo) drugs by IV—to kill cancer cells. Chemo may help to shrink the tumor before other treatment. It can also attack tumors that may have spread to other areas of the body.
  • Surgery—to remove the cancer. It is often done after chemo. The bone may also need repair after the tumor is removed. A bone graft or prosthesis may be needed to support the remaining bone. It may take a number of surgeries to get full use of the limb.
  • Radiation therapy—uses high-energy x-rays to kill tumor cells. It can help shrink tumors before a surgery. It may also be used instead of surgery.

A high-dose chemotherapy is being tested for Ewing sarcoma. The high dose kills off bone marrow. A stem cell transplant is then needed to help grow healthy bone marrow. This combination therapy may be used when other treatments do not work.


There are no guidelines to prevent Ewing sarcoma.





  • Bone tumors and bone sarcomas. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/bone-tumors-and-bone-sarcomas.
  • Ewing family of tumors. American Cancer Society website. Available at: https://www.cancer.org/cancer/ewing-tumor.html.
  • Ewing sarcoma treatment (PDQ)—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/bone/patient/ewing-treatment-pdq.
  • Ewing’s sarcoma. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/ewings-sarcoma.
  • Kharod SM, Spiguel AR, et al. Radiation treatment for Ewing sarcoma family of tumors in adult patients: a single institution's experience over 40 Years. Am J Clin Oncol. 2019;42(5):421-425.


  • Mohei Abouzied, MD, FACP
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.