Ewing Sarcoma: Diagnosis
If you or your child has symptoms of Ewing sarcoma, you’ll need certain exams and tests to be sure. Diagnosing Ewing sarcoma starts with your healthcare provider asking questions. He or she will ask you about health history, symptoms, risk factors, and family history of disease. The healthcare provider will also do a physical exam.
What tests might be needed?
You or your child may have one or more of the following tests:
Imaging tests are often done first if your healthcare provider suspects a bone tumor, such as Ewing sarcoma.
X-rays of the bone
This is often the first test done if your healthcare provider suspects a bone tumor. Healthcare providers can spot most Ewing tumors with an X-ray. An X-ray uses very low doses of radiation to see through your skin. It imprints an image of the inside of the body onto a piece of film.
Magnetic resonance imaging (MRI)
This test uses magnets and radio waves to take detailed pictures of the inside of your body. An MRI is often the next test done if an X-ray shows something suspicious. It can more clearly define abnormal areas to see if they’re due to a Ewing tumor.
Computed tomography (CT)
A CT scan uses X-rays taken from many angles to make detailed cross-section pictures of the bone and nearby tissues. A CT scan can help your healthcare provider spot a Ewing tumor. But this test isn’t used as often as MRI.
The results of imaging tests might suggest a bone tumor. But the only way to be sure is by taking out a piece of the tumor and looking at it under a microscope. This is called a biopsy. There are different ways to get a biopsy. It’s important that your biopsy is done by a healthcare provider with experience in treating this disease.
For this test, your healthcare provider uses a large, hollow needle. He or she puts it through your skin and into the bone tumor to get a sample of it. This type of biopsy doesn’t require surgery. In most cases, you’re awake for it. Your healthcare provider may use a CT scan to guide the needle into place.
If the tumor is large, a surgeon might remove only a small part of the tumor through a cut (incision) in your skin during an operation. If the tumor is close to your skin, the surgeon may numb the area. If the tumor is deep inside your body, you may need anesthesia to put you to sleep.
If the tumor is small, a surgeon might cut through your skin and take out (excise) the whole tumor. This type of operation usually requires general anesthesia. In this case, you’ll be asleep.
Getting your test results
When your health care provider has the results of the tests, he or she will contact you with the results. Your provider will talk with you about other tests that may be needed if Ewing sarcoma is found. Make sure you understand the results and what needs to be done next.
March 21, 2017
Clinical presentation, staging, and prognostic factors of the Ewing sarcoma family of tumors. UpToDate.
Alteri, Rick, MD,Gersten, Todd, MD