Symptoms of Ewing sarcoma

Ewing sarcoma is a relatively common tumor disease in clinical practice. Although it is common and affects a wide range of people, it is unfamiliar to ordinary people. When patients are facing the disease, in order to get better treatment results, in addition to following the doctor's instructions, they also need to have a detailed understanding of the disease. Let's take a look at the symptoms of Ewing sarcoma and its types.

Ewing sarcoma (ES) of bone is a poorly differentiated malignant tumor of small round cells. It accounts for 6% to 8% of all primary bone tumors and is the most common malignant primary bone tumor in children and adolescents. Pain and swelling are the most common early symptoms, followed by nerve damage such as nerve roots and spinal cord. Some patients have low fever, significantly increased serum high-density lipoprotein cholesterol and erythrocyte sedimentation rate, sometimes accompanied by increased white blood cell count and anemia. The lesion may produce a large soft tissue mass. A biopsy is required for diagnosis. Imaging evaluation includes detailed anatomical location, soft tissue invasion, extent of spinal canal invasion, and distant metastasis. The CAL staging system has been established based on these tumor and surgical factors. ES is mainly distributed in non-spinal structures, and spinal involvement is rare. The incidence rate is 3.5% to 5%.

Introduction

Ewing's sarcoma of bone is a malignant bone tumor that originates from mesenchymal cells of the bone marrow and is characterized by small round cells containing glycogen. The most common age group is children; the most common sites of occurrence are the femur, tibia, fibula, ilium and scapula. Ewing sarcoma is a rare malignant bone tumor, accounting for 7% of malignant bone tumors. It is common in adolescents aged 10 to 25 years old. It is rare in those under 5 years old or over 30 years old. The male to female ratio is approximately (2.0 to 2.5):1. The tumor is highly malignant, develops rapidly, and has a very poor prognosis. The disease can occur in any part of the skeleton, but the long bones of the limbs are the most common site, followed by the epiphysis. The femur, humerus, tibia, fibula and ilium are the most common bones affected, but the ribs, scapula, spine and skull can also be affected.

type

(1) Osteolytic type: bone destruction is the main feature, with a small amount of periosteal new bone or small spicule bone formation.

(2) Sclerotic type: Bone hyperplasia and sclerosis occur in the tumor area, and a large amount of needle-shaped and periosteal new bone appears outside the cortical bone. Bone destruction is difficult to observe, or only a small amount of bone destruction is visible.

(3) Mixed type: bone destruction and periosteal hyperplasia are basically equal in amount.

Clinical manifestations

symptom

1. Pain and swelling are the most common symptoms. Often, the pain has gradually intensified and become persistent in the period before admission to the hospital, with obvious local swelling or a lump that can be felt.

2. Inflammatory response manifests itself in rapid tumor growth with a wide reaction area, a large number of new blood vessels, and signs of inflammatory response such as redness, swelling, and heat.

3. Fractures Ewing sarcoma lesions of the main weight-bearing bones may cause pathological fractures.

4. Systemic symptoms may include moderate fever, weakness, weight loss, anemia and lethargy. It may also metastasize to the lungs early and lead to death.

The location of the tumor may also cause other symptoms. For example, lesions located at the lower end of the femur may affect the function of the knee joint and cause repeated joint effusion; lesions located at the ribs may cause pleural effusion, etc.

Signs

1. There is local tenderness, increased skin temperature, and dilated veins on the surface of the tumor.

2. Tumors that invade soft tissue often form soft, large masses.

3. Tumors occurring in the ribs are often accompanied by pleural effusion. Tumors occurring in the sacrum or pelvis may cause a series of neurological symptoms due to invasion of the sacral plexus. Tumors occurring in the pelvis may be very large and easily extend to the lower limbs. If the tumor is close to the end of the joint, it may cause limited joint movement and may be accompanied by joint effusion.