Ewing's Sarcoma

Question 1

What translocation is associated with Ewing’s sarcoma?

Answer 1

t(11:22) EWN-FL1

Question 2

What demographic is affected by Ewing’s sarcoma?

Answer 2

5-25yo; uncommon in african americans and Asians; most occur in the diaphysis

Question 3

What are the radiographic and histologic characteristics of Ewing’s sarcoma?

Answer 3

Large lytic areas of diaphysis; periosteum may have sunburst or onion skinning; bone scan will be very hot, MRI shows large soft tissue mass
Small round blue cells with scant cytoplasm, may have pseudo-rosettes
CD99 staining
ESR and WBC elevated

Question 4

What is required in the workup of suspected Ewing’s sarcoma?

Answer 4

Bone marrow aspirate

Question 5

What is the treatment for Ewing’s sarcoma?

Answer 5

Chemo for 8-12 weeks, wide resection, then maintenance chemo for 6-12 months; radiation can be used for non-resectable tumors or metastatic disease