Signs and Symptoms of Ewing Tumors

Ewing tumors (Ewing sarcomas) are most common in older children and teens, although they can develop in other age groups as well. These tumors are often found because of the symptoms they cause.

Pain

Most people with Ewing tumors will have pain in the area of the tumor. Ewing tumors develop most often in the pelvis (hip bones), the chest wall (such as the ribs or shoulder blades), or the legs (mainly in the middle of the leg bones), but they can also start in other parts of the body. At first, the area might not hurt all the time, and the pain might be worse at night or with activity. Over time, the pain might become more intense and more constant.

Less often, a person might feel sudden, intense pain from a break (fracture) in a bone that has been weakened by a tumor.

Lump or swelling

Over time, most Ewing bone tumors and almost all non-bone (soft tissue) Ewing tumors cause a lump or swelling, which is more likely to be noticed in tumors in the arms or legs. The lump is often soft and feels warm. Tumors in the chest wall or pelvis might not be noticed until they have grown quite large.

Other symptoms

Ewing tumors can also cause other symptoms, some of which are more common in tumors that have spread:

  • Fever
  • Feeling tired
  • Weight loss

Rarely, tumors near the spine can affect nearby nerves, which can lead to back pain, as well as weakness, numbness, or paralysis in the arms or legs.

Tumors that have spread to the lungs can cause shortness of breath.

Many of the signs and symptoms of Ewing tumors are more likely to be caused by something else. Still, a person with any of these symptoms, especially if they don’t go away or get worse, should see a doctor so the cause can be found and treated, if needed.

Because many of these signs and symptoms can be confused with normal bumps and bruises, or with infections, Ewing tumors might not be recognized right away. For example, the doctor might try giving antibiotics first if an infection is suspected. The correct diagnosis might not be made until the signs and symptoms don’t go away (or get worse) and the painful area is then x-rayed.

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Anderson ME, Dubois SG, Gebhart MC. Chapter 89: Sarcomas of bone. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

DeLaney TF, Hornicek FJ. Clinical presentation, staging, and prognostic factors of the Ewing sarcoma family of tumors. UpToDate. Accessed at www.uptodate.com/contents/clinical-presentation-staging-and-prognostic-factors-of-the-ewing-sarcoma-family-of-tumors on October 30, 2020.

National Cancer Institute. Ewing Sarcoma Treatment (PDQ). 2020. Accessed at https://www.cancer.gov/types/bone/patient/ewing-treatment-pdq October 30, 2020.

References

Anderson ME, Dubois SG, Gebhart MC. Chapter 89: Sarcomas of bone. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

DeLaney TF, Hornicek FJ. Clinical presentation, staging, and prognostic factors of the Ewing sarcoma family of tumors. UpToDate. Accessed at www.uptodate.com/contents/clinical-presentation-staging-and-prognostic-factors-of-the-ewing-sarcoma-family-of-tumors on October 30, 2020.

National Cancer Institute. Ewing Sarcoma Treatment (PDQ). 2020. Accessed at https://www.cancer.gov/types/bone/patient/ewing-treatment-pdq October 30, 2020.

Last Revised: May 25, 2021

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