• Ewing Sarcoma—Child

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

    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. Prognosis depends on the location of the tumor and whether it has spread to other parts of the body.
    Leg and Pelvic Bones—Common Sarcoma Sites
    Leg bones
    Copyright © Nucleus Medical Media, Inc.

    Causes

    It is thought that Ewing sarcoma is caused by a genetic problem.

    Risk Factors

    Ewing sarcoma is more common in Caucasians, teenagers, and males.

    Symptoms

    Symptoms may include:
    • Pain, redness, and swelling surrounding the tumor
    • Difficulty moving around
    • Fever
    • Weight loss and reduced appetite
    • Fatigue
    • Loss of bladder control
    • Numbness, tingling, and paralysis
    • Difficulty breathing
    Ewing sarcoma can also weaken the bone leading to unexplained fracture of the bone.

    Diagnosis

    You will be asked about your child’s symptoms and medical history. A physical exam will also be done. Ewing may be suspected if a bone breaks after a minor injury. A sample of the tissue will be removed and sent for examination, also called a biopsy.
    Images of the body may be taken to locate the tumor and determine if it has spread to other tissues. Images may be taken with:

    Treatment

    Your child will work with a team of doctors. They will determine the best treatment options for your child. These options include:

    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 injected into a vein, and travel to the bone cavities where 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 are no current guidelines to prevent Ewing sarcoma because the cause is unknown.

    RESOURCES

    American Cancer Society http://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 http://www.caringforkids.cps.ca

    References

    Ewing sarcoma. Boston Children's Hospital website. Available at: http://www.childrenshospital.org/conditions-and-treatments/conditions/ewing-sarcoma. Accessed September 6, 2016.

    Ewing sarcoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114929/Ewing-sarcoma. Updated October 29, 2014. Accessed September 6, 2016.

    General information about Ewing sarcoma. National Cancer Institue website. Available at: http://www.cancer.gov/types/bone/patient/ewing-treatment-pdq. Updated May 18, 2016. Accessed September 6, 2016.

    Revision Information

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