Ewing's sarcoma

Ewing sarcoma (including primitive neuroectodermal tumor of bone / PNET) is the second-most common primary malignant bone cancer in children and adolescents, but is also seen in adults.

The most frequent sites of involvement are the long bones and pelvis. All forms of Ewing sarcoma are high grade tumors

Biopsy

- Biopsy diagnosis is mandatory

- Biopsy to be done only after all local imaging is completed

- In most cases a core needle biopsy is adequate (it may need to be image-guided depending on anatomical location of the lesion)

- Immunohistochemistry confirmation desirable, may need additional cytogenetic and molecular studies

Serological investigations

- Though there are no specific laboratory tests for diagnosis some maybe of prognostic value; e.g. alkaline phosphatase (ALP) and lactate dehydrogenase (LDH)

Staging

- Local X-Ray

- Full length MRI

- PET CT Scan. If PET not available Bone Scan + CT Thorax & Bone Marrow aspiration & biopsy