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. They 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 need one or more of the following tests:
Imaging tests
Imaging tests are the first things done if the healthcare provider thinks you or your
child may have a bone tumor, such as Ewing sarcoma.
X-rays of the bone
This is often the first test done. An X-ray uses very low doses of radiation to get
pictures of bones and organs. It imprints an image of the inside of the body onto
a piece of film. Healthcare providers can see most bone tumors on an X-ray, and may
even be able to tell if it's likely a Ewing sarcoma.
MRI
This test uses magnets and radio waves to take detailed pictures of the inside of
the body. An MRI is often the next test done if an X-ray shows something suspicious.
It can more clearly define changed areas to see if the problem is a Ewing tumor or
if it's some other bone damage or an infection. MRI can show details of the tissue
around the tumor, as well as the inside of the bone with the tumor.
Biopsy
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 changed bone and looking at it under a microscope.
This is called a biopsy. There are different ways to get a bone biopsy. It’s important
that the healthcare provider doing the biopsy is working with a healthcare provider
who has experience in treating Ewing sarcoma. This is to be sure that the way the
skin is cut or the piece of tumor is taken out does not affect later treatment with
radiation or surgery.
Needle biopsy
For this type of bone biopsy, your healthcare provider uses a large, hollow needle.
They put it through your skin and into the bone tumor to get a tiny piece of it. This
type of biopsy doesn’t need surgery. In most cases, you’re awake for it, but the area
is made numb. Your healthcare provider may use a CT scan to help guide the needle
into the right place.
Incisional biopsy
If the tumor is large, a healthcare provider might take out a small part of it through
a cut (incision) in your skin. If the tumor is close to the skin, you or your child
may be given medicines to make you sleepy. The surgeon will numb the area to do the
biopsy. If the tumor is deep inside your body, you may need general anesthesia. In
this case, medicines are used to put you into a deep sleep so you don't feel pain
while the biopsy is done.
Excisional biopsy
If the tumor is small, a surgeon might cut through the skin and take out (excise)
the whole tumor. This type of surgery often needs general anesthesia. This means you’ll
be in a deep sleep.
Getting your test results
When your healthcare provider has the results of the tests, they will contact you.
Your provider will talk with you about other tests that may be needed for you or your
child if Ewing sarcoma is found. Make sure you understand the results and what needs
to be done next.