The medical history (history of the patient) represents an important component in the diagnosis of Ewing sarcoma. Family history Social history Current anamnesis/systemic anamnesis (somatic and psychological complaints). Do you suffer from persistent or increasing pain in the skeletal system for which there is no identifiable cause? Does the pain also occur at night or … Ewing’s Sarcoma: Medical History
Infectious and parasitic diseases (A00-B99). Bone tuberculosis-2-3% of all tuberculosis cases involve the skeletal system, of which approximately 50-60% involve the spine; peak incidence: 40-60 years of age. Musculoskeletal system and connective tissue (M00-M99). Fibrodysplasia ossificans progressiva (FOP; synonyms: Fibrodysplasia ossificans multiplex progressiva, Myositis ossificans progressiva, Münchmeyer syndrome) – genetic disorder with autosomal dominant inheritance; … Ewing’s Sarcoma: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by Ewing sarcoma: Neoplasms – Tumor Diseases (C00-D48). Metastasis (daughter tumors) – esp. to the lungs, but also to the rest of the skeleton, bone marrow, rarely regional lymph nodes Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99). … Ewing’s Sarcoma: Complications
The following tumor types are distinguished on the basis of their histologic (fine-tissue) characteristics and site of origin: Classical Ewing sarcoma (EWS). Peripheral malignant primitive neuroectodermal tumor (PPNET). Askin tumor of the thoracic wall (chest wall). Soft tissue Ewing tumor Lodwick classification By means of the Lodwick classification, it is possible to assess whether the … Ewing’s Sarcoma: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body temperature, body weight, body height; further: Inspection (viewing). Skin and mucous membranes Neck Extremities: [Swelling? may be reddish in color; size; consistency; displaceability of skin from underlying surface. Deformities of joints and bones? Skin … Ewing’s Sarcoma: Examination
The clinical presentation depends on the size or extent, location, and stage. The following symptoms and complaints may indicate Ewing sarcoma: Main symptoms Bone pain independent of exertion (pressure and knocking pain) that also occurs at rest and/or at night and increases in intensity Swelling, deformity of joints and bones (palpable) – swelling may be … Ewing’s Sarcoma: Symptoms, Complaints, Signs
Pathogenesis (disease development) Ewing sarcoma is one of the osteomyelogenous tumors, meaning that it arises from the bone marrow space from mesenchymal stem cells (immature/undifferentiated tissue cells). It is small-, blue-, and round-celled and highly malignant (highly aggressive; malignancy grade 3 or 4). Ewing’s sarcoma consists almost entirely of tumor cells that replace destroyed bone … Ewing’s Sarcoma: Causes
General measures Nicotine restriction (refraining from tobacco use). Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day). Limited caffeine consumption (max 240 mg of caffeine per day; equivalent to 2 to 3 cups of coffee or 4 to 6 cups of green/black tea). Aim for normal weight! … Ewing’s Sarcoma: Therapy
1st order laboratory parameters – obligatory laboratory tests. Biopsy (tissue sample) – to determine the type of tumor as well as its aggressiveness; most important diagnostic measure in cases of suspected tumor; performed following imaging procedures (see “Medical Device Diagnostics“)Caveat: When performing this procedure, possible effects on the upcoming tumor resection and subsequent reconstruction must … Ewing’s Sarcoma: Test and Diagnosis
Therapeutic targets Relief of pain Stabilization of bone sections at risk of fracture Reduction of tumor size – preoperatively (before surgery) by radiotherapy (radiotherapy) or chemotherapy (neoadjuvant chemotherapy). Removal of the tumor – see “Surgical therapy“. Healing Therapy recommendations Therapy depends on the type and extent of the bone tumor. Most often, therapy consists of … Ewing’s Sarcoma: Drug Therapy
Obligatory medical device diagnostics. Conventional radiography of the affected body region and adjacent joints, in two planes-to assess the extent of tumor growth; show (see “Lodwick classification” below): Moth-eaten destruction (destruction) of the bone. Periosteal spur (“Codman triangle”) Onion skin-like calcification of the periosteum (periosteum). Computed tomography (CT; sectional imaging procedure (X-ray images from different … Ewing’s Sarcoma: Diagnostic Tests
In Ewing’s sarcoma, the goal is removal in healthy tissue with a margin of safety (tumor-free resection margins). The following form of surgical therapy is available: Wide resection – method of choice for malignant (malignant) bone tumors. Procedure: wide and radical resection (surgical removal) of the tumor with a safety margin of 5 cm (proximal … Ewing’s Sarcoma: Surgical Therapy