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Ewing Sarcoma—Child

  • Amy Scholten, MPH
Publication Type:


Ewing Sarcoma—Child

(Peripheral Primitive Neuroectodermal Tumors—Child; PNET—Child; Ewing's Family of Tumors—Child)


Ewing sarcoma is a cancer that develops in bone or soft tissue. The areas commonly affected include the pelvis, thigh, lower leg, upper arm, and chest wall.

Leg and Pelvic Bones—Common Sarcoma Sites.

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Cancer is when cells in the body split without control or order. These cells go on to form a growth or tumor. 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.


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

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


The doctor will ask about the child's symptoms and health history. A physical exam will also be done. Ewing sarcoma may be suspected if a bone breaks after a minor injury. A sample of the tissue will be taken and tested with a biopsy.

Other tests include:

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. Chemo may be used with radiation therapy.
  • 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.
  • Surgery may be used to remove the tumor. Surgery may also be done to rebuild the affected bone. A bone graft will help to replace smaller areas of missing bone. An artificial limb may be needed if larger areas of bone are affected. Special artificial limbs can expand as the bone grows. Several surgeries may be needed to make sure the limb functions properly.

Other treatments may include:

  • A Stem cell transplant—to replace stem cells damaged from the cancer and treatments. Stem cells grow into blood cells and platelets. Stem cells from a donor are given through an IV.
  • Physical and occupational therapy—to help the child:
    • Relearn how to do daily tasks
    • Return to physical activity
    • Learn how to use an artificial limb

Other therapists or specialists will also help the child cope with the illness and treatment.


There are no guidelines to prevent Ewing sarcoma.





  • Eaton BR, Claude L, et al. Ewing sarcoma. Pediatr Blood Cancer. 2021;68 Suppl 2:e28355.
  • Ewing sarcoma. Boston Children's Hospital website. Available at: https://www.childrenshospital.org/conditions/ewing-sarcoma.
  • Ewing sarcoma in children. EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/ewing-sarcoma-in-children.
  • Ewing sarcoma treatment (PDQ)—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/bone/patient/ewing-treatment-pdq.


  • 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.