Carl R. Darnall Army Medical Center - Health Library

Ewing Sarcoma—Child

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

Pronounced: YOO-ingz sar-KOH-muh

Definition

Ewing sarcoma is a type of cancer that occurs in the bone or soft tissue. Areas that are commonly affected include the pelvis, thigh, lower leg, upper arm, and chest wall.

Leg and Pelvic Bones—Common Sarcoma Sites
Leg bones

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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. The term cancer refers to harmful growths. These growths attack nearby tissues. They also spread to other parts of the body. It’s not clear exactly what causes these problems. It’s likely a mix of genes and the environment.

Risk Factors ^

Risk factors are not clear since the cause is unknown. This type of cancer is more common in male teenagers who are White.

Symptoms ^

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

  • Pain which:
    • May come and go or be constant
    • Range from mild to severe
    • May include feeling of pins and needles
  • Redness and swelling around the area
  • Fatigue
  • Fever
  • Weight loss and reduced appetite
  • Broken bone with no known cause

Diagnosis ^

The doctor will ask about your 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 removed and looked at in a lab. This is also called a biopsy.

Other tests:

Treatment ^

The goal of treatment is to remove or kill as much of the cancer as possible. It will be based on the tumor’s size and location. Treatment may include one or more of these:

Chemotherapy and Radiation Therapy

Chemotherapy is the use of drugs to kill cancer cells. Chemotherapy may be used along with radiation therapy. This is the use of high-energy x-rays to kill cancer cells.

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 the bone are affected. There are special types of artificial limbs that expand as the bone grows. Several surgeries may be needed to make sure the limb functions properly.

Stem Cell Transplant

Stem cells grow into blood cells and platelets. The cancer and the treatments can damage stem cells which makes it difficult for the body to produce healthy blood cells. A stem cell transplant can help replace the damaged stem cells. The new cells are placed through an IV. They travel to the bone marrow sites. Once there, they will grow and change into different types of blood cells. Blood cells include red and white blood cells, and platelets.

Rehabilitation Therapy

Physical and occupational therapy will help your child manage physical challenges including:

  • Relearning how to do daily tasks
  • Resuming physical activity
  • Learning how to use a prosthesis

Other therapists or specialists will also help your child through emotional challenges of illness and treatment.

Prevention ^

There is no way to prevent Ewing sarcoma since the cause is unknown.

RESOURCES:

American Cancer Society
https://www.cancer.org

Healthy Children—American Academy of Pediatrics
https://www.healthychildren.org

CANADIAN RESOURCES:

Ewings Cancer Foundation of Canada
http://ewingscancer.ca

Caring for Kids—Canadian Paediatric Society
https://www.caringforkids.cps.ca

REFERENCES:

Ewing sarcoma. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/e/ewing-sarcoma. Accessed August 1, 2018.

Ewing sarcoma in children. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T114929/Ewing-sarcoma-in-children. Updated April 27, 2018. Accessed August 1, 2018.

Ewing sarcoma treatment (PDQ)—patient version. National Cancer Institute website. Available at: https://www.cancer.gov/types/bone/patient/ewing-treatment-pdq. Updated July 9, 2018. Accessed August 1, 2018.

Primary malignant bone tumors. Merck Manual Professional Version website. Available at: https://www.merckmanuals.com/professional/musculoskeletal-and-connective-tissue-disorders/tumors-of-bones-and-joints/primary-malignant-bone-tumors. Updated February 2017. Accessed August 1, 2018.

Last reviewed June 2018 by EBSCO Medical Review Board Mohei Abouzied, MD, FACP  Last Updated: 8/1/2018