Ewings sarcoma

BY DR. GIRIDHAR BOYAPATI PG DEPT. OF ORTHOPAEDICS

Lab investigations

ESR is elevated WBC is elevated CRP is elevated. anemia is common lactic dehydrogenase

Biopsy Gross appearance

may have liquid consistency mimicking pus.

Characteristic findings:

1.sheets of monotonous small round blue cells.

2.prominent nuclei and minimal cytoplasm.

3.may have

pseudorosettes (circle of cells with necrosis in center)

DD

Small-round-cell tumor differential (by age)

< 5 yrs: Neuroblastoma or leukemia 5-10 yrs: Eosinophilic granuloma 5-30 yrs: Ewing's sarcoma >30 yrs: lymphoma > 50 yrs: myeloma

Post-treatment considerations

Recurrence of primary disease is the major risk in the first 10 years after diagnosis.

A second malignancy occurs in approximately 1-2% of patients beginning 5 years after diagnosis; the most common second malignancy is Acute myeloid leukemia.

Therapeutic toxicities to the heart and kidneys, to the nervous and endocrine systems.