Ewing Sarcoma Symptoms, Causes & Treatment Options

Ewing sarcoma is a rare tumor in the bone of children and adolescents that requires surgery and generally has an excellent prognosis if treated early by a specialist.

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  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Ewing Sarcoma?


Ewing sarcoma is a rare disease affecting several hundred (usually white) children, adolescents, and young adults every year. It is a cancer of the bone and can occur in the legs, pelvis, chest, upper extremities, spine, hands/feet, and skull, in order of commonness. It typically causes pain and tenderness at the affected site, and limping can often be seen. When caught by a physician and treated by an expert, the prognosis is generally excellent. However, the disease can also spread to other organs in the body in later stages. There is no way to prevent Ewing sarcoma.

Recommended care

Ewing Sarcoma Symptoms

Main symptoms

The most common symptoms include:

  • Pain/tenderness: The pain increases over time.
  • Limping
  • Stiffness
  • Feeling a lump/swelling
  • Fever
  • Breaking a bone easily
  • Fatigue
  • Weight loss

Other symptoms

Advanced (progressed) disease can cause the following symptoms:

  • Shortness of breath: due to metastasis to the lungs
  • Weakness/Numbness: due to tumor near the spinal cord
  • Anemia: low blood count

Places where Ewing sarcoma can occur

Following are the different areas where a tumor can occur, in order of commonness:

  • Legs
  • Pelvis
  • Chest wall
  • Arms
  • Spine
  • Hands
  • Feet
  • Skull

Ewing Sarcoma Causes

Ewing sarcoma is caused by a genetic abnormality called a chromosome 11, 22 translocation. The reason that the translocation occurs is currently unknown, and it is not inherited, which means it is not transmitted through families. This causes the growth of certain cells forming a tumor. This tumor takes up space and thus causes bone pain, which can be extremely painful. It also weakens the integrity of the bone, which allows for fractures even under conditions that wouldn’t normally cause fracture. In addition, if the tumor continues to grow without treatment, it can spread to other places in the body such as the lungs and the brain.

Risk factors

  • Male gender
  • White race: The disease is exceedingly rare in other racial groups.
  • Age: The disease most commonly develops in teens.

Ewing Sarcoma Symptom Checker

Take a quiz to find out if your symptoms point to Ewing sarcoma

Treatment Options, Relief, and Prevention for Ewing Sarcoma


The diagnosis of Ewing sarcoma can be supported by imaging or biopsy findings. In biopsies, a sample of tissue is taken out and examined under a microscope to see if it looks like Ewing sarcoma. This can be performed using a needle or it may need to be done surgically, depending on the location of the tumor. Sometimes, a sample of your bone marrow will be taken and analyzed

Imaging studies can also be performed, which include:

  • X-ray
  • CAT scan
  • MRI: a non-radiating imaging alternative to CAT scan
  • PET scan: This is used to see if the cancer has spread to other locations.
  • Radionuclide bone scan

Other diagnostic tools include blood tests, which may be able to see if you have the genetic mutation for Ewing sarcoma.

The treatment usually includes surgery. Surgery should be performed at a large center with experienced surgeons who specialize in bone cancer for the best results. 90% of children can have local surgery that spares the limb, but some children will need an amputation. Children who need an amputation will benefit from the use of prosthetics to enable normal activities.

Other treatment options include:

  • Chemotherapy
  • Radiation therapy
  • Proton therapy
  • Joint replacement

After surgery, rehabilitation and follow-up care are necessary to resume functioning and ensure adequate treatment.


Ewing sarcoma cannot be prevented.

When to Seek Further Consultation for Ewing Sarcoma

Seek the advice of a pediatric physician if you note that your child is limping and complaining of a deep pain that doesn’t go away. Other signs of disease include swelling and tenderness over the affected bone. Always seek the advice of a physician when your child has a fever that will not go away or has unexplained weight loss or fatigue.