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Understanding Ewing Sarcoma: Types, Symptoms, Stages, Diagnosis, and Treatment | Medanta

 Ewing sarcoma is an uncommon kind of cancer that develops in the soft tissue surrounding the bones or in the bones themselves

Ewing sarcoma can develop in any bone, however, it typically starts in the pelvic and leg bones. Less frequently, it begins in the limbs, abdomen, chest, or other soft tissues.

Ewing sarcoma can develop at any age, but it is more common in children and teenagers.

The prognosis for those who have Ewing sarcoma has improved as a result of significant developments in the disease's management. It is advised that patients be monitored for the rest of their lives to look out for any potential long-term effects of aggressive chemotherapy and radiation.

Types: 

  1. Ewing sarcoma of bone - The most frequent tumor in this family is Ewing sarcoma, which begins in the bone. Dr. James Ewing originally identified this form of tumor in 1921 and noted that it was distinct from osteosarcoma, a more typical bone tumor. Its cells appeared different from osteosarcoma cells when viewed under a microscope. Radiation therapy was also more likely to be effective.
  2. Extraosseous Ewing tumor (EOE) - Extraosseous Ewing tumors begin in the soft tissues surrounding bones, but they resemble Ewing sarcomas in the bones in both appearance and behavior. Ewing sarcomas extraskeletal are another name for them.
  3. A peripheral primitive neuroectodermal tumor (PPNET) - Many characteristics of Ewing sarcoma of bone and EOE are shared by this uncommon childhood cancer, which also begins in soft tissue or bone. Skin tumors are a subtype of peripheral PNETs that originate in the chest wall.

Researchers have discovered a striking similarity between the cells that make up Ewing sarcoma, EOE, and PPNET. They frequently share proteins and share DNA (gene) abnormalities that are uncommon in other types of cancer. Because of this, it is believed that these cancers originate in the same kind of body cells. These tumors differ slightly from one another, but they are all treated in the same manner.

Symptoms:

  1. Swelling, tenderness, or discomfort close to the affected area
  2. A bone ache
  3. Unaccounted for fatigue
  4. Without a known cause, a fever
  5. Shedding pounds without trying

Stages:

Healthcare professionals employ a more straightforward system for practical considerations (such as selecting a course of therapy). 

This separates Ewing cancers into two categories:

  1. Localized cancer - Only the tissue (such as bone or muscle) where it first originated seems to be affected by the malignancy. Additionally, it could be in neighboring tissues like lymph nodes. Imaging tests and bone marrow biopsies show that it hasn't migrated to other body regions. However, it's still possible that small quantities of cancer may have moved to other locations even if imaging tests reveal no evidence of cancer in other body regions. Chemotherapy, which may destroy cells anywhere in the body, is a crucial component of the Ewing sarcoma treatment 
  2. Metastatic cancer - From the initial location of cancer, it has spread to other body regions. This could be the bone marrow, the lungs, or other bones. It rarely spreads to the liver or lymph nodes.

Diagnosis:

The healthcare professional for your child will begin with a physical examination and medical history. The following may also be employed:

  1. X-ray
  2. Magnetic resonance imaging (MRI)
  3. Computed tomography (CT) scan
  4. Positron emission tomography (PET) scan

Treatment:

The type of cancer that is being treated differs depending on the Ewing sarcoma. However, before starting treatment, you might think about getting yourself, your child, and other family members some psychological help. When you or your child receives a diagnosis of Ewing sarcoma, you may experience fear, tension, and anxiety. Your family may feel more prepared for treatment if you seek therapy or assistance from a support group.

Ewing sarcoma treatment involves:

  1. Chemotherapy.
  2. Radiation therapy.
  3. Radiation therapy is followed by surgery to eliminate any leftover cancer cells.
  4. The medication used in this therapy targets particular alterations in cancer cells.

Conclusion:

A type of cancer that most commonly occurs in and around the bones.

Ewing's sarcoma is most common in children and young adults. It frequently begins in the legs, pelvic bones, and arms. Symptoms include bone pain, swelling, and tenderness. Bone fractures may also be discovered in rare cases. Chemotherapy, surgery, and radiation are all options for treatment.


 

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Dr. Saif N Shah
Orthopaedics
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