Ewing's Sarcoma

 

Welcome to PT 635 Pathophysiology of Complex Patient Problems This is a wiki created by and for the students in the School of Physical Therapy at Bellarmine University in Louisville KY. Please do not edit unless you are involved in this project, but please come back in the near future to check out new information!!

Original Editors - Lisa Miville from Bellarmine University's Pathophysiology of Complex Patient Problems project.

Lead Editors - Your name will be added here if you are a lead editor on this page.  Read more.

Definition/Description

Ewing’s Sarcoma is a high grade malignant primary tumor that can arise in soft tissue or bone. It is often referred to as a family of tumors known as Ewing family of tumors (EFT).^1-4  The tumor is named after James Ewing who first discovered the small, blue round cell that was distinct from osteogenic sarcoma.⁴ Although any bone can be invovled, the most common are the pelvis, femur, tibia, ulna and metatarsals.⁷  Close behind is the ribs and vertebral column.³ EFT is most common in children between the ages of 5 and 16, and due to recent availability of multi-agent cytostatic approaches and local therapy, the 5 year survival rate has increased from 10% to 70%.^4,6 Prognosis is dependent on metastisis, worsening with widespread involvement.    26% of patients with EFT have metatstic disease: 10% to the lungs, 10% to bone/bone marrow, and 6% combination.³

Prevelance

Ewing's Sarcoma is the second most common primary malignant bone tumor of children and the fourth more common overall. 80% of these tumors occur in people under the age of 20 and they have been reported in children as young as 5 months. They rarely occur in the African American or Asian population.^1,2 EFT is more common in males than females 1.5:1.^1,3,4,6,8

Characteristics/Clinical Presentation

Pain is usually the intial symptom.  may be worse during exercise or at night.  Pain is often intermittent.  There is often swelling and warmth.

Associated Co-morbidities

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Medications

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Diagnostic Tests/Lab Tests/Lab Values

Chemotherapy, radiation, surgical resection, limb salvage, amputation.^1,2

Etiology/Causes

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Systemic Involvement

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Medical Management (current best evidence)

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Physical Therapy Management (current best evidence)

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Alternative/Holistic Management (current best evidence)

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Differential Diagnosis

Osteomyelitis - swelling, redness, low grade fever and flu-like symptoms may be present in both conditions.

Case Reports/ Case Studies

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Resources

1.  Pathophysiology book
2. MedlinePlus

3. UK guidelines

4. Ewing Tumor, INcidence, prognosis and treatment

5.Kids health.org

6. Goodman C, Snyder T. Differential Diagnosis for Physical Therapists: Screening for Referral. St. Louis, MO: Saunders Elsevier: 2007 
7.  Powerpoint from complex patient

Recent Related Research (from Pubmed)

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References

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