What is Ewing’s Sarcoma in Children?
Sarcomas are cancers that begin in the body's connective tissues.
Sarcomas are often divided into two groups. One group is the bone cancers which begin in the hard part of the bone. The other group is the soft tissue sarcomas which start in the muscles, fat, fibrous tissue, blood vessels, nerves, or other supporting tissues of the body.
Ewing's sarcoma is a form of cancer that can be found in both the bone or in the soft tissue, depending on the type. It is the second most common malignant bone tumor of children and young adults and accounts for about 2 to 3 percent of all childhood tumors. Nearly half of all cases are in individuals 10-20 years of age. Frequent sites include the bones of the leg, upper arm, pelvis, ribs, spine and pelvis. It is a fast-growing cancer that easily spreads to the lungs or to other bones.
Ewing’s Sarcoma Symptoms
Symptoms of Ewing's sarcoma include swelling and pain. The pain is often worse at night. There may also be a soft mass at the site of the pain. At first, the pain may be thought to be the result of an injury. Depending on the location of the mass, other symptoms may include problems with urination or constipation, difficulty breathing, shortness of breath, or numbness and weakness of the extremities. Often a fracture, or break in the bone, occurs as a result of the tumor weakening the bones. Sometimes it is hard to tell tumor from a bone infection called osteomyelitis.
Ewing’s Sarcoma Diagnosis
Diagnosis of Ewing's sarcoma is made by biopsy of the tumor. This is a surgical procedure performed under general anesthesia so the child is not conscious and will not feel any pain. Then a small part of the suspicious bone or soft tissue is removed and looked at under a microscope. A signature sign of Ewing’s sarcoma is round blue cells seen under the microscope by the pathologist.
Besides the biopsy, additional tests are done to stage the disease or see if the disease has spread. These tests may include a chest X-ray, bone scan, CT scans, MRI, PET scan, a bone marrow aspirate and biopsy and sentinel node biopsy.
Ewing’s Sarcoma Treatment
Treatment for Ewing’s sarcoma may involve a combination of surgery, chemotherapy, radiation and, in some situations, targeted drug agents.
In some situations, the doctor may recommend an autologous bone marrow rescue.
Another possibility is using proton therapy instead of traditional radiation therapy. Proton therapy targets the tumor while avoiding organs and healthy tissue. This means fewer short-term side effects and long-term complications from radiation. Cincinnati Children’s is one of only a few pediatric hospitals in the country that offers proton therapy.
Your child's treatment plan will be based on the specific pathology of the tumor, the location of the tumor, whether the tumor has spread, and if there is any residual tumor after surgery.