Diagnosing Ewing Sarcoma

Pictured: Leonard Wexler & Joanna Moulton
A proper diagnosis leads to proper treatment. When our doctors suspect that a child has Ewing sarcoma, they confirm the diagnosis using x-rays, CT scans, MRI, and a sample of the affected tissue. Children who need a tissue sample taken are usually put under anesthesia before the procedure.
After doctors have diagnosed Ewing sarcoma, they use what they have collected to find out the stage (extent) of the tumor. This shows how advanced the cancer is, and if and where it has spread. Because Ewing sarcoma can spread widely throughout the body, our experts often look at bone marrow and use imaging studies such as chest CT scans, PET scans, and bone scans to determine stage.
We test for genetic changes in all patients thought to have Ewing sarcoma. When a patient has a tumor that looks like Ewing sarcoma but that doesn’t seem to have one of the genetic changes usually found in the disease, we perform more precise tests to make the correct diagnosis. Doctors at MSK were the first to identify unique gene rearrangements in tumors that look like Ewing sarcoma.
Almost all patients with Ewing sarcoma have cancer in other parts of the body, but it may not be visible or detectable. Patients with Ewing sarcoma fall into one of two stages: Patients whose cancer looks like it hasn’t spread have localized Ewing sarcoma. Patients whose cancer has visibly spread have metastatic Ewing sarcoma.