Ewing’s sarcoma is called oncological pathology, which is characterized by the formation of a malignant tumor on the surface of a flat or long tubular bone (mainly in the lower third). The defeat of tubular bones is characteristic of neoplasms that have appeared in young patients, flat bones are more often affected in patients older than twenty years.
Reasons
The specific causes of the development of Ewing’s sarcoma are unknown to modern medicine. It is proved that hereditary predisposition and injuries of the musculoskeletal system received in childhood or adolescence play an important role in its appearance. Congenital anomalies of the skeletal structure and the effects of carcinogenic factors (in particular, high doses of ionizing radiation) increase the risk of tumor formation.
Symptoms
The clinical picture is determined by the localization of the tumor. In the vast majority of cases, the tumor develops on one of the tubular bones forming the lower extremities, or the bones of the pelvis. Less often the bones of the shoulder girdle are affected, even less often the ribs, shoulder blades, collarbones and other bones, including the bones of the skull.
In the early stages, the patient notes unexpressed pain in the projection of the affected bones or nearby joints, which increases with physical exertion. In the future, the pain occurs spontaneously, including at night, does not weaken at rest, even after complete immobilization of the limb, it stops spontaneously. As the tumor increases, the intensity of the pain syndrome also increases, which causes sleep disorders, a decrease in the level of motor activity, and in severe cases, functional disorders on the part of the affected limb, up to its complete immobilization.
Localization of the tumor in the rib area is accompanied by difficulty in breathing, limitation of the volume of chest movements.
A tumor localized on one of the vertebrae manifests itself in the same way as various radiculopathies and osteochondrosis.
In addition to the pain syndrome, the patient may note that in the area of the greatest pain, a redness and swelling of the skin appeared, which became hotter to the touch, compared with the surrounding tissues. Bone fractures often occur in this area.
The general well-being of the patient suffers to varying degrees. In the early stages, there may be a slight malaise, periodic subfebrility. As the tumor grows, fever becomes more frequent, there is an unreasonable decrease in body weight, pronounced physical weakness. There are signs of anemia: dizziness, flashing “flies” in front of the eyes, deterioration of the skin and its appendages.
With the formation of metastases, there are signs of damage to the organ into which the tumor cells have penetrated. The lungs are most often affected, which is manifested by dry cough, shortness of breath, respiratory failure and hemoptysis.
Diagnostics
The diagnosis is made on the basis of the patient’s complaints, the data of his objective examination and the results of an additional examination:
radiographs;
computed tomography;
magnetic resonance imaging;
ultrasound examination;
immunohistochemical analysis.
When a tumor is detected, a fragment of it is removed for histological examination. In order to determine or exclude the presence of metastases, molecular genetic studies, osteoscintigraphy, angiography are carried out.
Basic principles of treatment
Complex therapy is used – surgical removal of the tumor, chemotherapy and radiation therapy. The need for such an approach is dictated by the tendency of Ewing’s sarcoma to the rapid formation of multiple metastases.
