Ewing Sarcoma

Ewing sarcoma is a highly cancerous tumor derived from primitive bone marrow. It is seen especially in children and adolescents between 4-15 years and rarely develops in adults over 30 years.Ewing sarcoma has over 33% of bone tumors. It is the second malignant bone tumor in young adults and the most deadly bone tumor. There is an association between Ewing sarcoma and peripheral primitive neuroectodermal tumors.
Symptom onset is intermittent pain becomes intense. Radiating pain in the limbs and spine especially in pelvic tumors.Neurological signs such as the root and spinal cord compression are present with impaired axial skeleton. The clinical picture may be similar to chronic or acute osteomyelitis and remittances include fever, mild anemia, leukocytosis, red blood cells and high sedimentation rate. Some patients may have palpable masses that grow rapidly, with local swelling and tenderness. Patients with lung metastases may present with asymmetric breath sounds, signs of pleural or rales. Patients with metastases in the bone marrow may present with thrombocytopenia, petechiae or purpura.
The survival rate of patients with Ewing's sarcoma depends on the initial manifestation of the disease. Over 80% of patients have localized disease while 20% shows clinically detectable metastatic disease in lung, bone and bone marrow. The survival rate is 60%, and for those with 70% local tumor. Patients with metastatic disease had survival of 25%.Due to the limited prognosis for Ewing's sarcoma is important to diagnose the accuracy of morphological imaging methods, operational procedures and histological analysis. Differentiating Ewing's sarcoma of osteomyelitis requires histological examination. Extension of tumor to be recognized.
Ewing sarcoma pathogenesisThe tumor is derived from bone marrow but histology is associated with reticular cell sarcoma. Monoostotica lesion is frequently diagnosed in metaphysics or shaft of long bones of the extremities.The tumor may occur more frequently in the pelvic area, ribs and scapula. In fact any bone can be affected. Typical reaction and formation of new bone periosteala with onion bulb appearance suggests the diagnosis of Ewing's sarcoma. Radiographic appearance varies from one up to the dominant lithic sclerotic.Ewing sarcoma and peripheral neuroepiteliomul Ewing tumor family owned and are considered neural tumors. Ewing sarcoma is a form of less differentiated tumor, while neuroepiteliomul a differential form. Unlike neural neuroblastoame these tumors are not derived from the sympathetic system and catecholamine matabolitii are excreted in urine. In vitro these tumors shows neural differentiation and neural characteristics.
Signs and symptomsEwing sarcoma occurs mostly in children between 4-15 years and rarely in adults. Although it is unusual virstinici been reported in people of 60 years. It is the most lethal form of bone malignancy.Ewing sarcoma is rare that there is no screening program.Symptom onset, and most importantly, intermittent pain becomes intense. Radiating pain in the limbs and spine especially in pelvic tumors. Neurological signs such as the root and spinal cord compression are present in 50% of patients with impaired axial skeleton. Rarely patients may develop pathologic fractures.
Occasionally the clinical picture may be similar to chronic or acute osteomyelitis and remittances include fever, mild anemia, leukocytosis, red blood cells and high sedimentation rate.Increased serum lactic dehydrogenase, and weight loss are also present. Symptoms lasting up to several weeks to several months.Some patients may have palpable masses that grow rapidly, with local swelling and tenderness. The tumor is classified as primitive or metastatic. The prognosis is mediated by tumor type.Ewing tumors can occur in virtually any location. Examination of the painful places are critical inspection and palpation. Because patients may be adjacent bone disease can be described and neuropathic pain. It will perform a neurological examination for the presence of tingling, weakness or pain. Patients with lung metastases may present with asymmetric breath sounds, signs of pleural or rales. Patients with metastases in the bone marrow may present with thrombocytopenia, petechiae or purpura.
The following are associated with adverse prognostic factors:-Male, age 12 years-Anemia, high levels of lactic dehydrogenase-Radiotherapy for local controlChemotherapy-negative response.Disease progression:The survival rate of patients with Ewing's sarcoma depends on the initial manifestation of the disease. Over 80% of patients have localized disease while 20% shows clinically detectable metastatic disease in lung, bone and bone marrow. The survival rate is 60%, and for those with 70% local tumor. Patients with metastatic disease had survival of 25%.