• Ewing’s Sarcoma—Child

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

    Definition

    Ewing's 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’s sarcoma is caused by a problem with the chromosomes. Certain chromosomes (numbers 11 and 22) are rearranged. This rearrangement causes some genes to be fused together.

    Risk Factors

    Some factors that increase the risk include:
    • Race: People who are African American or Asian are at a lower risk compared to Caucasians.
    • Age: More common among teenagers
    • Gender: Slightly more common among males

    Symptoms

    Symptoms may include:
    • Pain, redness, and swelling surrounding the tumor
    • Difficulty moving around
    • Fever
    • Weight loss and reduced appetite
    • Fatigue
    • Paralysis and loss of bladder control (in cases where the tumor is near the spinal cord)
    • Numbness, tingling, and paralysis (caused by compression of nerves by the tumor)
    • Difficulty breathing if the tumor is in the chest wall
    These symptoms may be caused by other, less serious conditions. If your child has any of these, talk to the doctor.

    Diagnosis

    The doctor will ask about your child’s symptoms and medical history. A physical exam will also be done. Tests may include:
    • Bone scan —to detect presence of a tumor in other bones
    • CT scan —a type of x-ray that uses a computer to look for cancer that has spread to other areas
    • MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
    • PET scan —to evaluate the metabolic activity of tissue
    • Blood tests—to determine abnormalities in the blood
    • Biopsy —to determine exactly what kind of cells the tumor is made of

    Treatment

    Your child will work with a team of doctors. Talk with the team to 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 also be used to remove the tumor, as well as rebuild the affected bone. Depending on the location of the tumor, a bone graft or prosthesis (artificial limb) may be needed. There are special types of prostheses that expand as the bone grows. Sometimes several surgeries are needed to make sure the limb functions properly.

    Stem Cell Transplant

    Stem cells produce red and white blood cells, as well as platelets. Because of the cancer and the treatments, your child’s stem cells may be damaged. During a stem cell transplant , new cells are injected into a vein, and travel to the bone cavities.

    Rehabilitation Therapy

    Your child will need to work with a team of therapists, such as:
    • Occupational therapist to help your child learn how to do daily tasks
    • Physical therapist to help your child with physical activity, especially if he has a prosthesis
    The team will also provide support as your child goes through treatment.

    Prevention

    There is no known way to prevent this condition.

    RESOURCES

    Cancer Index http://www.cancerindex.org/

    United States National Library of Medicine http://www.nlm.nih.gov/

    CANADIAN RESOURCES

    About Kids Health http://www.aboutkidshealth.ca

    Alberta Children's Services http://www.child.alberta.ca/home/

    References

    Children’s Hospital Boston. Ewing’s sarcoma. Children’s Hospital Boston website. Available at: http://www.childrenshospital.org/az/Site852/mainpageS852P0.html . Accessed June 30, 2010.

    Children’s Hospital of Wisconsin. Ewing sarcoma. Children’s Hospital of Wisconsin website. Available at: http://www.chw.org/display/PPF/DocID/22003/router.asp . Accessed June 30, 2010.

    DynaMed Editorial Team. Ewing sarcoma. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated June 29 , 2010. Accessed June 30, 2010.

    Kohnle D, Kellicker P. Ewing’s sarcoma. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 30, 2010. Accessed June 30, 2010.

    Nelson Textbook of Pediatrics, 18th Edition. RM Kliegman, HB Jenson, RE Behrman, BF Stanton, Editors. Saunders Elsevier, Philadelphia PA, 2007.

    Revision Information

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