Diagnosis
Accurate diagnosis of Ewing sarcoma is necessary for providing appropriate treatment to the patients. The diagnosis of Ewing sarcoma can be made through the following methods:
- Medical history and physical examination: During the physical examination, the development, severity, and progression of symptoms are investigated and analyzed. The age of the patients is also taken into consideration during the diagnosis of Ewing sarcoma, as this condition is more likely to occur in teenagers and children.
- Complete blood count: The patients may also be advised to undergo a complete blood cell analysis to determine the overall health of the body and to rule out the presence of underlying medical conditions that may mimic the symptoms of Ewing sarcoma. The hemoglobin level, platelets, white blood cells, inflammatory mediators, and hemoglobin were evaluated during blood tests.
- Blood chemistry analysis: The patients are recommended to undergo various blood panels tests, such as liver function tests and kidney function tests, to rule out underlying conditions causing the symptoms. These tests may also help to detect if Ewing sarcoma has reached distant organs, such as the liver.
- X-ray: This technique is one of the initial imaging techniques used for analyzing the bone if a palpable mass is detected during physical examination. Radiographic imaging may help detect the primary malignant tumor by evaluating the periosteal reactions and tumor-related osteolysis in bones.
- Magnetic resonance imaging: This technique uses strong magnets and powerful radio waves to create a 3-D image of the affected organ. Magnetic resonance imaging may also be used to detect the metastasis of Ewing sarcoma to other organs.
- CT scan: Computed tomography scan uses X-ray and advanced technology to create the images from several angles (in slices) and then overlap them to visualize the images on a computer. CT scan assists in studying the structural changes or the presence of a lump of tumor in several parts of the body, including muscles, organs, fats, and bones.
- PET scan: This technique involves the principle that rapidly dividing cells require more energy than cells with normal division. This technique delivers a small dose of radioactive-tagged sugar into the vessels. The sugar is tracked with a special camera showing rapidly dividing cells, such as cancer cells, at a particular site.
- Bone scan: The bone scan may also be recommended to analyze the size, shape, and location of the lump or tumor. The bone scan takes around 3 to 4 hours to complete. During the bone scan, a radioactive isotope is injected into the vessels. The patients are asked to wait 2 to 3 hours, and the radioactive isotope is absorbed into the bone. The isotope is then traced by scanning the patients from head to toe. The radiologists may ask the patients to empty the bladder before undergoing imaging.
- Biopsy: Biopsy is the confirmatory diagnosis in almost all cases of cancer. During the procedure, the samples of the abnormal tissues are obtained and sent to a laboratory to determine the presence of cancer cells. There are two types of biopsy conducted for diagnosing Ewing sarcoma. These include:
- Fine needle aspiration biopsy: A thin needle is guided to the tumor with an imaging technique, such as a CT scan (CT-guided biopsy), and the sample is drawn from the site.
- Surgical biopsy: In cases where the fine needle aspiration technique is not feasible, or there is a need for obtaining large samples, the patients may undergo surgical biopsy. During this technique, an incision is made on the skin, and the tumor is removed. The procedure is known as an excisional biopsy if the complete tumor is removed. If the portion of the tumor is removed, the procedure is known as an incisional biopsy.
