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Ewing's sarcoma in children

Sarcoma d'Ewing en els infants a Vall d'Hebron

It is a cancer found in the bones and soft tissue. Ewing's sarcoma is the second most common cancer in children, and normally occurs between ten and twenty years old. It is also more common in males than in females. Ewing's sarcoma and primitive neuroectodermal tumours (PNET) are cancers encompassing different types of malignant tumours that share a common chromosomic abnormality. Ewing’s tumours are made up of small undifferentiated cells and tend to be most commonly found in the long bones of the leg or arm, in the flat bones of the ribs and pelvis, or in the spine. They may also occur in any other bone or in soft tissue.

 

 

Description

Ewing's tumours located in soft tissue are called  extraskeletal Ewing’s sarcoma. They tend to be found in the thigh,  pelvis, parts of the spine, the chest wall and the foot.

Primitive neuroectodermal tumours  in bones and soft tissue are the least common type of Ewing’s sarcoma. They are made up of immature nerve cells.

 

Symptoms

The most common symptoms of Ewing’s sarcoma are:

  • Pain
  • Stiffness
  • Tenderness in the area of the tumour  

There may also be a lump or swelling around the affected bone or tissue. During diagnosis it is very common to discover a pathological fracture (a non-traumatic fracture) due the fact that the tumour has weakened the bone. Weight loss and fever are other very common symptoms of this kind of tumour.

 

Who is affected by Ewing’s sarcoma?

Malignant neoplasms in children and teenagers are rare, but they are one of the most important causes of morbidity and mortality in these age groups. Ewing’s sarcoma represents 3 % of cancers diagnosed in children throughout Spain. Every year there are around 30 new cases in children under 14 years of age.

 

Diagnosis

If a child shows symptoms of this sarcoma, the doctor will carry out several diagnostic tests which may include:

  • X-ray
  • CT scan (tomography)
  • Magnetic Resonance Imaging (MRI)
  • Bone scintigraphy
  • Tumour biopsy
  • Bone marrow aspiration and biopsy  

These tests will help to determine the size and location of the tumour and whether it has spread to other parts of the body.

 

Typical treatment

Three kinds of treatment are often used to treat Ewing’s tumours. Chemotherapy is always used. In addition, surgery (whether to save or amputate the limb) and radiotherapy are used for local control of the tumour. The type of treatment depends on the child's age, the location of the tumour and whether it has spread to other parts of the body.

 

Prevention

There are currently no measures to prevent this kind of tumour. 

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