Ewing Sarcoma—Child

Definition

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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Causes

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

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

Diagnosis

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:

• Blood tests—to see if bone tissue was damaged
• Image tests to show the size and location of the tumor, such as:
  • X-rays
  • CT scan
  • MRI scan
  • Bone scans
  • PET/CT scan

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

Treatment

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.

Prevention

There are no guidelines to prevent Ewing sarcoma.