Ewing's sarcoma: Difference between revisions

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{{Infobox_Disease |
__NOTOC__
  Name          = Ewing's sarcoma |
  DiseasesDB    = 4604 |
  ICD10          = |
  ICD9          = {{ICD9|170.9}} |
  ICDO          = 9260/3 |
  OMIM          = |
  MedlinePlus    = 001302 |
}}
{{Ewing's sarcoma}}
{{Ewing's sarcoma}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''.
 
{{CMG}}; '''Assistant Editor(s)-In-Chief:''' [[User:Michael Maddaleni|Michael Maddaleni, B.S.]]
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
 
{{CMG}};{{AE}} {{PSK}} '''Assistant Editor(s)-In-Chief:''' [[User:Michael Maddaleni|Michael Maddaleni, B.S.]]
 
{{SK}} Ewing sarcoma; Ewings sarcoma


==[[Ewing's sarcoma overview|Overview]]==
==[[Ewing's sarcoma overview|Overview]]==


==[[Ewing's sarcoma epidemiology and demographics|Epidemiology and Demographics]]==
==[[Ewing's sarcoma historical perspective|Historical Perspective]]==


==[[Ewing's sarcoma historical perspective|Historical Perspective]]==
==[[Ewing's sarcoma classification|Classification]]==


==[[Ewing's sarcoma pathophysiology|Pathophysiology]]==
==[[Ewing's sarcoma pathophysiology|Pathophysiology]]==


==Clinical findings==
==[[Ewing's sarcoma causes|Causes]]==
Ewing's sarcoma is more common in males and usually presents in childhood or early adulthood, with a peak between 10 and 20 years of age. It can occur anywhere in the body, but most commonly in the [[pelvis]] and proximal long tubular bones. The [[diaphyses]] of the [[femur]] are the most common sites, followed by the [[tibia]] and the [[humerus]]. Thirty percent are overtly [[metastasis|metastatic]] at presentation.


The most common clinical findings are pain and swelling diarrhea.
==[[Differentiating Ewing's sarcoma from other diseases|Differentiating Ewing's sarcoma from other diseases]]==


==Imaging findings==
==[[Ewing's sarcoma epidemiology and demographics|Epidemiology and Demographics]]==
 
On conventional [[radiography|radiographs]], the most common osseous presentation is a permeative lytic lesion with [[periosteum|periosteal]] reaction. The classic description of lamellated or "onion skin" type [[periosteum|periosteal]] reaction is often associated with this lesion.  Plain films add valuable information in the initial evaluation or screening. The wide zone of transition (e.g. permeative) is the most useful plain film characteristic in differention of benign versus aggressive or malignant lytic lesions.
 
[[Magnetic resonance imaging|MRI]] should be routinely used in the work-up of malignant tumors. MRI will show the full bony and soft tissue extent and relate the tumor to other nearby anatomic structures (e.g. vessels). [[Gadolinium]] contrast is not necessary as it does not give additional information over non contrast studies, though some current researchers argue that dynamic, contrast enhanced MRI may help determine the amount of necrosis within the tumor, thus help in determining response to treatment prior to surgery.


[[Computed axial tomography|CT]] can also be used to define the extraosseous extent of the tumor, especially in the skull, spine, ribs and pelvis. Both CT and MRI can be used to follow response to radiation and/or [[chemotherapy]].
==[[Ewing's sarcoma risk factors|Risk Factors]]==


Bone [[scintigraphy]] can also be used to follow tumor response to therapy.
==[[Ewing's sarcoma screening|Screening]]==


==Differential diagnosis==
==[[Ewing's sarcoma natural history|Natural History, Complications and Prognosis]]==


Other entities that may have a similar radiologic presentation include osteomyelitis, [[osteosarcoma]] (especially telangiectatic osteosarcoma) and eosinophilic granuloma. Soft tissue neoplasms such as malignant fibrous histiocytoma that erode into adjacent bone may also have a similar appearance.
==Diagnosis==
[[Ewing's sarcoma staging|Staging]] | [[Ewing's sarcoma history and symptoms|History and Symptoms]] | [[Ewing's sarcoma physical examination|Physical Examination]] | [[Ewing's sarcoma laboratory tests|Laboratory Findings]] | [[Ewing's sarcoma x ray|X Ray]] | [[Ewing's sarcoma CT|CT]] | [[Ewing's sarcoma MRI|MRI]]  | [[Ewing's sarcoma other imaging findings|Other Imaging Findings]] | [[Ewing's sarcoma other diagnostic studies|Other Diagnostic Studies]]


==Treatment==
==Treatment==
[[Ewing's sarcoma medical therapy|Medical therapy]] | [[Ewing's sarcoma surgery|Surgery]] | [[Ewing's sarcoma primary prevention|Primary prevention]]  | [[Ewing's sarcoma secondary prevention|Secondary prevention]] | [[Ewing's sarcoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Ewing's sarcoma future or investigational therapies|Future or Investigational Therapies]]


Because almost all patients with apparently localized disease at diagnosis have occult metastatic disease, multi drug [[chemotherapy]] as well as local disease control with surgery and/or radiation is indicated in the treatment of all patients. Treatment often consists of neo-adjuvant [[chemotherapy]] generally followed by wide or radical excision, and may also include [[radiotherapy]]. Complete excision at the time of biopsy may be performed if malignancy is confirmed at that time. Treatment lengths vary depending on location and stage of the disease at diagnosis. Radical chemotherapy may be as short as 6 treatments at 3 week cycles, however most patients will undergo chemotherapy for 6-12 months and radiation therapy for 5-8 weeks.
==Case Studies==
[[Ewing's sarcoma case study one|Case#1]]


==Prognosis==
==External Links==
* [http://cancer.gov/cancertopics/pdq/treatment/ewings/healthprofessional National Cancer Institute listing for Ewing's sarcoma]


Staging attempts to distinguish patients with localized from those with [[metastasis|metastatic]] disease. Most commonly, [[metastasis|metastases]] occur in the chest, bone and/or bone marrow. Less common sites include the [[central nervous system]] and [[lymph node]]s.
[[fr:Sarcome d'Ewing]]
 
[[pl:Mięsak Ewinga]]
Survival for localized disease is 65-70% when treated with [[chemotherapy]]. Long term survival for [[metastasis|metastatic]] disease can be less than 10% but some sources state it is 25-30%.
[[pt:Sarcoma de Ewing]]
 
==References==
{{reflist|2}}
 
==External links==
* [http://cancer.gov/cancertopics/pdq/treatment/ewings/healthprofessional National Cancer Institute listing for Ewing's sarcoma]


[[Category:Disease state]]
[[Category:Disease]]
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Types of cancer]]
[[Category:Types of cancer]]
[[Category:Oncology]]
[[Category:Oncology]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]
[[fr:Sarcome d'Ewing]]
[[pl:Mięsak Ewinga]]
[[pt:Sarcoma de Ewing]]


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Latest revision as of 23:19, 26 November 2017

Ewing's sarcoma Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2] Assistant Editor(s)-In-Chief: Michael Maddaleni, B.S.

Synonyms and keywords: Ewing sarcoma; Ewings sarcoma

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Ewing's sarcoma from other diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging | History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical therapy | Surgery | Primary prevention | Secondary prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case#1

External Links


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