More About Ewing Sarcoma 

Ewing sarcoma is a rare type of cancer. It’s most common in children and teens between the ages 10 and 19. It usually grows in bone, but it can also grow in soft tissue that’s connected to the bone. This may include tendons, ligaments, cartilage, or muscles.

Ewing sarcoma most often grows in:

  • Bones of the legs, hips and pelvis, chest, and arms
  • Soft tissue of the torso, arms, and legs
The exact cause of Ewing sarcoma is not known. The cancer may be caused by changes in the DNA of the cells. These changes are not passed on from parents to children. They happen by chance.

Symptoms can occur a bit differently in each child. They can include:

  • Pain around the site of the tumor that may come and go, but gets worse over time, with activity, and at night
  • Swelling  around the site of the tumor
  • A lump (mass)
  • Fever
  • Weight loss
  • Feeling tired

The symptoms of Ewing sarcoma can be like other health conditions. Make sure your child sees a healthcare provider for a diagnosis.

Your child's healthcare provider will ask about your child's health history and symptoms. He or she will examine your child.  Your child may be referred to a specialist. This may be a bone specialist (orthopedic surgeon) or a bone cancer specialist (orthopedic oncologist). Your child may have tests such as:

  • X-ray. An X-ray uses a small amount of radiation to take pictures of bones and other body tissues.
  • Blood tests. The blood is tested to look for signs of Ewing sarcoma. Genetic testing may also be done to look for DNA changes that can cause the cancer.
  • CT scan. This test uses a series of X-rays and a computer  to make detailed images of the body.
  • MRI. This test uses large magnets, radio waves, and a computer to make detailed images of the inside of the body.
  • Bone scan. A small amount of dye is injected into a vein. The whole body is scanned. The dye shows up in areas where there may be cancer.
  • Positron emission tomography (PET) scan. For this test, a radioactive sugar is injected into the bloodstream. Cancer cells use more sugar than normal cells, so the sugar will collect in cancer cells. A special camera is used to see where the radioactive sugar is in the body. A PET scan can sometimes spot cancer cells in different areas of the body, even when they can’t be seen by other tests. This test is often used in combination with a CT scan. This is called a PET/CT scan.
  • Bone marrow aspiration or biopsy. Bone marrow is found in the center of some bones. It’s where blood cells are made. A small amount of bone marrow fluid may be taken. This is called aspiration. Or solid bone marrow tissue may be taken. This is called a core biopsy. Bone marrow is usually taken from the hip bone. This test may be done to see if cancer cells have reached the bone marrow.
  • Tumor biopsy. A sample of the tumor is taken. It may be taken with a needle or by a surgical cut (incision). It is checked under a microscope for cancer cells. A biopsy is needed to diagnose neuroblastoma. 

Part of diagnosing cancer is called staging. Staging checks the size and location of the main tumor, if it has spread, and where it has spread. Ewing sarcoma may be stage 1, 2, or 3 with sub-stages. Talk with your child's oncologist about your child's stage and what it means. Staging also helps to decide the treatment.