Ewing’s Sarcoma

Ewing’s sarcoma is a small round cell tumor. It arises inside the bone.

Ewing’s Sarcoma Clinical Features

It occurs predominantly in children and young adults between 5 to 25 years with median age of 13 years.
It is more common in males as compared to females.
Whites develop this tumor more commonly but in blacks not even single case is reported.
Pain in Ewing’s sarcoma is intermittnt in nature.
Swelling of the bone is earliest clinical sign.
Long bones of extremities are more commonly affcted besides these skull, clavicle, ribs, shoulder are also affcted.
Ewing’s sarcoma in occur more commonly in mandible as compared to maxilla
Paresthesia and loosening of teeth are common fidings in Ewing’s sarcoma of jaw.
Appearance of jaw swelling is rapid and intraoral mass become ulcerated.
Tumor commonly penetrates the cortex resulting in soft tissue mass which overlie affected area of bone.

Most common fiding is formation of layers of new subperiosteal bone which produces onion skin appearance of fim.
There is presence of irregular lytic bone destruction with ill-defied margins.

Benign and malignant tumors of Oral cavity Ewing’s sarcoma 1

Ewing’s sarcoma is highly cellular which consists of solid sheets or mass of small round cells with litte stroma, few connective tissue septa can also be seen.
Cells are small and round in shape having scanty cytoplasm. Nuclei of cell is large round to oval in shape with dispersed chromatin and hyperchromasia.
Borders of cell are indistinct.
Cells are arranged in filigree pattern.
Mitotic figures are commonly seen.
Multiple small vascular channels are also present.
Hemorrhage with vascular lakes or sinuses can be seen.
There is also presence of geographic necrosis with perivascular sparing.
Necrosis can be seen on the opposite side of fragment of bone.

Radical surgical excision should be done alone or coupled with Xray radiation.
Current treatment consists of combined surgery, radiotherapy and multidrug chemotherapy which led to 40 to 80% of survival rates.