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</div><div><span>Ewing sarcoma</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Ewing sarcoma</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Ewing sarcoma is a malignant <a test="test" href="./001230.htm">bone tumor</a> that forms in the bone or soft tissue around it. It affects mostly teens and young adults.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Ewing sarcoma can occur anytime during childhood and young adulthood. But it usually develops during puberty, when bones are growing rapidly. It is more common in White children than in Black or Asian children.</p><p>The tumor may start anywhere in the body. Most often, it starts in the <a test="test" href="./002249.htm">long bones</a> of the arms and legs, the pelvis, or the chest. It can also develop in the skull or the <a test="test" href="./002366.htm">flat bones</a> of the trunk.</p><p>The tumor often spreads (<a test="test" href="./002260.htm">metastasizes)</a> to the lungs and other bones. At the time of diagnosis, spread is seen in about one third of children with Ewing sarcoma. </p><p>In rare cases, Ewing sarcoma occurs in adults.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>There are few symptoms. The most common is pain and sometimes swelling at the site of the tumor.</p><p>Because the tumor weakens the bone, children may also break a bone at the site of the tumor after a minor injury.</p><p>Fever may also be present.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>If a tumor is suspected, tests to locate the primary tumor and any spread (metastasis) often include:</p><ul><li><a test="test" href="./003833.htm">Bone scan</a></li><li><a test="test" href="./003804.htm">Chest x-ray</a></li><li><a test="test" href="./003788.htm">CT scan of the chest</a></li><li><a test="test" href="./003335.htm">MRI</a> of the tumor</li><li>X-ray of the tumor</li></ul><p>A <a test="test" href="./003923.htm">biopsy</a> of the tumor will be done. Different tests are done on this tissue to help determine how aggressive the cancer is and what treatment may be best.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>Treatment often includes a combination of:</p><ul><li><a test="test" href="./002324.htm">Chemotherapy</a></li><li><a test="test" href="./001918.htm">Radiation therapy</a></li><li><a test="test" href="./002305.htm">Surgery</a> to remove the primary tumor</li></ul><p>Treatment depends on the following:</p><ul><li><a test="test" href="../patientinstructions/000850.htm">Stage </a>of the cancer</li><li>Age and sex of the person</li><li>Results of the tests on the biopsy sample </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Support Groups</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>The stress of illness can be eased by joining a <a test="test" href="./002166.htm">cancer support group</a>. Sharing with others who have common experiences and problems can help you not feel alone.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Before treatment, outlook depends on:</p><ul><li>Whether the tumor has spread to distant parts of the body</li><li>Where in the body the tumor started</li><li>How large the tumor is when it's diagnosed</li><li>Whether the <a test="test" href="./003499.htm">lactate dehydrogenase</a> (LDH) level in the blood is higher than normal</li><li>Whether the tumor has certain gene changes</li><li>Whether the child is younger than 15 years</li><li>Child's sex</li><li>Whether the child has had treatment for a different cancer before Ewing sarcoma</li><li>Whether the tumor has just been diagnosed or has come back</li></ul><p>The best chance for cure is with a combination of treatments that includes chemotherapy plus radiation or surgery.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>The treatments needed to fight this disease may have many complications. Discuss these with your health care provider.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Contact your provider if your child has any of the symptoms of Ewing sarcoma. An early diagnosis can increase the possibility of a favorable outcome.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Bone cancer - Ewing sarcoma; Ewing family of tumors; Primitive neuroectodermal tumors (PNET); Bone neoplasm - Ewing sarcoma; Ewing's sarcoma</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1233t.jpg" alt="Ewing sarcoma - X-ray" title="Ewing sarcoma - X-ray" class="side-img"/><a href="../imagepages/1233.htm">Ewing sarcoma - x-ray</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Heck RK, Toy PC. Malignant tumors of bone. In: Azar FM, Beaty JH, eds. <em>Campbell's Operative Orthopaedics</em>. 14th ed. Philadelphia, PA: Elsevier; 2021:chap 27.</p><p>National Cancer Institute website. Ewing sarcoma and undifferentiated small round cell sarcomas of bone and soft tissue treatment (PDQ) - health professional version. <a href="https://www.cancer.gov/types/bone/hp/ewing-treatment-pdq" target="_blank">www.cancer.gov/types/bone/hp/ewing-treatment-pdq</a>. Updated April 19, 2024. Accessed May 15, 2024.</p><p>National Comprehensive Cancer Network website. NCCN clinical practice guidelines in oncology (NCCN guidelines): Bone cancer. Version 2.2024. <a href="https://www.nccn.org/professionals/physician_gls/pdf/bone.pdf" target="_blank">www.nccn.org/professionals/physician_gls/pdf/bone.pdf</a>. Updated March 12, 2024. Accessed May 15, 2024.</p></div></div></section>
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