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Bone & Soft Tissue Cancers (Ewing sarcoma)

Ewing sarcoma is the second most common type of bone cancer after osteosarcoma in adolescents, young adults, and adults. This tumor usually affects pelvis, long bones and ribs and can also affect soft tissues (known as extraosseous Ewing sarcoma). This type is found in the torso, arms, legs, head, and neck.

Causes of Ewing sarcoma

The exact cause of Ewing sarcoma is unknown; most of cases are sporadic, but some specific genetic abnormalities may increase the risk of developing it.

Symptoms of Ewing sarcoma

  • Pain and/or swelling, in the affected location. The pain increases at night, is not related to physical activity, and does not respond to over-the-counter painkillers such as Panadol.
  • A lump which develops 2-3 months after the onset of pain
  • Unexplained bone fractures
  • Limitation of joint movement if the tumor arises in a region close to a joint
  • Fever, fatigue, and in more advanced cases, weight loss

Diagnosis of Ewing sarcoma

It is diagnosed by taking an x-ray of the bone and performing a biopsy. A biopsy removes a sample of bone and tissue to further examine for abnormalities. An MRI scan of the affected limb is necessary to estimate the local spread of the disease, while a chest CT scan is needed to evaluate the spread of the disease to the lungs. A bone scan is also needed to evaluate the spread of disease to other bones, while bone marrow biopsies are taken to rule out the spread of cancer in the bone marrow.

Treatment of Ewing sarcoma at KHCC

Treatment lasts few months and consists of alternating courses of chemotherapeutic regimens. The patient will need hospitalization for the administration of specific chemotherapy regimen.

Management of the primary tumor site is critical to achieving a long-term cure. Any surgery should be performed by an experienced oncologic surgeon specialized in the area of the body where the tumor is found. Local control may be achieved with radiation therapy, though doses to the tumor and fractionation are site dependent.


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