Ewing's Sarcoma :: Nationwide Children's Hospital

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Ewing's Sarcoma

Ewing's sarcoma is a form of cancer that usually starts in the bone. The tumor occurs in the shaft of the long bones of the arms and legs and in the bones of the trunk (see Picture 2). It is found most often in people between the ages of 10 and 25. The cause of Ewing's sarcoma is not known. It is not thought to be inherited or contagious (catching).

Signs and Symptoms

The most common symptom is bone pain that keeps getting worse. There may also be swelling, redness and tenderness of the tissues over the affected bone. Other signs include fever, weight loss and fatigue. The spread of cancer to other places in the body is called metastasis (meh-TASS-tah-sis). The most common places for Ewing's sarcoma to spread to are the lungs and other bones. When there is spread of the cancer, it is usually present at diagnosis.

Image of X-ray

Picture 1: Having an X-ray


The first step in diagnosis is a biopsy. In a biopsy, a tiny sample of the tissue of the a

ffected bone is examined under a microscope. An X-ray of the bone may show possible Ewing's sarcoma, but the biops

y is still needed to be sure ( see Picture 1). A surgeon will do the biopsy in the operating room. A pathologist will then look at the tissue under the microscope.
Because Ewing's sarcoma can spread to other parts of the body, a careful look for this spread is made before any further surgery or treatment is done. A chest X-ray and computed tomography (CT) scan will be done to check for spread to the lungs. X-rays of all the bones in the body and a bone scan are done to see if there are tumors in any other bones. A bone marrow test and bone marrow biopsy are done to check for spread of disease to the bone marrow.

Medical Treatment

Treatment for Ewing's sarcoma involves surgery for biopsy or removal of tumor, chemotherapy, radiation or both. Chemotherapy is given over a period of 8 to 12 months and requires hospitalization for 3 to 6 days each time.
Surgical treatment usually happens after several cycles of chemotherapy. The type of surgery depends on where the tumor is located.


Image of skeletal system

Picture 2: The skeletal system (bones) inside the body

Follow-Up Appointments

You will have follow-up appointments with a hematologist/oncologist who will check your child's progress.
Every few months there will be X-rays or bone scans to check for signs of the tumor getting smaller or returning.
Blood tests will be done to check for side effects of therapy.
If you have any questions or concerns, please be sure to talk with your doctor or nurse.

Ewing's Sarcoma (PDF)

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