Ewing’s sarcoma in children

Epidemiology

Ewing's sarcoma is a tumor most commonly seen in adolescence. Indeed, 2 in every 3 patients are between the age of 10 and 20.

It typically starts in cells situated near bones and can erode the bones which can sometimes present as a bone tumor. It most commonly occurs in the lower limbs, upper limbs and, more rarely, the pelvis, spine and ribs.

Symptoms

There are various different symptoms.

If the tumor is relatively superficial, the patient will have noticed a lump that tends to grows quickly over a few weeks.

If the tumor has eroded a bone, it weakens the bone and can cause a pathological fracture, which is a fracture following a minor fall which would not have damaged a healthy bone.

Some patients have very vague symptoms and complain of a change in general health and fever. The doctor consulted will detect the presence of an unexplained tumor

Diagnosis

A variety of tests and investigations are needed to identify:

  • The exact nature of the disease through a biopsy. This involves taking a sample of the tumor. This is performed by a surgeon chosen according to the location of the lesion. A small incision is made to a fragment of tissue which will be analyzed by different laboratories (cytology, histology, genetics). The results are only available after a few days.
  • The location, which is identified by means of local examinations such as CT scan or magnetic resonance imaging (MRI).
  • The potential spread of the disease which requires a PET scan examination and/or a bone marrow biospy/aspiration.

Other important examinations are also requested to ensure that the patient is able to tolerate treatment at the doses usually administered:

  • Echocardiogram, ECG
  • Kidney function test

Treatment

Chemotherapy is generally given before local treatment and continued afterwards to destroy any remaining cancer cells. It is generally administered for a period of approximately one year.

Local treatment can be carried out either via surgery (resection of as much of the tumor as possible) or via radiotherapy. In certain cases, these two methods may be used together.

Local treatments often have orthopedic consequences that require regular physiotherapy to ensure the best possible recovery of daily activities.

Contact

For any further information, or if you would like to make an appointment, please contact the pediatric hematology and oncology secretary at + 32 2 764 23 50.