Ewings Sarcoma

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  • arises from vascular endothelium of bone
  • affects children and teenagers
    • common age 10-20 years
  • men > women
  • most frequently affects
    • diaphysis of long bones
    • pelvis
    • ribs
  • widespread metastases frequent
  • bone marrow is often involved

Clinical features

  • pain
  • swelling
    • warm
    • tender

Histology

  • small, darkly staining undifferentiated cells
  • neuroendocrine origin

Investigations

  • raised ESR
    • confusion with osteomyelitis
  • X-ray
    • large, soft tissue mass
    • concentric layers of new bone formation
    • "onion skin" appearance
  • characteristic chromosomal abnormality
    • (t11;22)(q24;q12)
 

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