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Ewing Sarcoma - Symptoms, Signs and Causes

Home> Ewing sarcoma> Symptoms and Causes

Ewing sarcoma does not cause any symptoms in most patients during the early stages of the disease. Also, the commonly observed Ewing tumor symptoms, such as fatigue, bone pain, and loss of appetite, overlap with other conditions. The exact cause of Ewing sarcoma is not known.

Who is mainly affected by Ewing Sarcoma?

Ewing sarcoma may occur to any person. However, specific populations are more likely to develop this condition than others. Ewing sarcoma commonly occurs in individuals during puberty, as there is rapid bone growth during this period. Children between the ages of 10 and 20 are more likely to be affected by Ewing sarcoma. Males are at higher risk of developing this condition than females.

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What are the Ewing Sarcoma Symptoms?

Some of the Ewing sarcoma symptoms include:

Bone Pain

Bone pain is one of the most common Ewing sarcoma symptoms. During the early stage of the disease, the patients do not experience persistent pain; instead, the pain occurs during the night, exercise, or other activities. However, as the disease progresses, the size of the tumor grows, resulting in persistent pain. In some cases, the patients may experience intense pain due to a fracture of the bone, which is weakened by the cancer. The common sites for developing Ewing sarcoma include the chest wall, pelvis, and legs.

Lumps near the skin surface

Patients may also experience a lump on the skin surface as an Ewing sarcoma symptom. The tumor that was small during the early stage of the disease progressively gets bigger, and the patients may start noticing a lump or growth on the skin's surface. In most cases, the tumor is noticed in the Ewing sarcoma of the hands and legs. However, tumors of the chest wall can also be noticed in patients with advanced diseases.

Swelling in the tissue around bones

Patients may also experience swelling at the site of the tumor. The swelling is more pronounced when the surrounding soft tissues are involved. It is to be considered that the tumor is present for a long time before it causes pain and swelling. In some patients, the swelling is progressive.

Fatigue

Fatigue is an Ewing sarcoma symptom that occurs during the progression of the disease and treatment. There are several reasons for experiencing fatigue. Ewing sarcoma may result in a loss of appetite, resulting in less food consumption. It results in weakness and fatigue. Further, tumor-induced hypermetabolic states are another cause of fatigue. During this state, the malignant cells compete with the healthy cells for nutrition, resulting in fatigue. Chronic pain also results in fatigue. Apart from this, cancer therapy, such as radiation therapy and chemotherapy, also causes significant fatigue.

Fever

Patients with Ewing sarcoma also experience fever as a malignancy manifestation, particularly known as neoplastic fever. The fever as an Ewing sarcoma symptom may occur due to the production of cytokines, such as interleukin-1, interleukin-6, and tumor necrosis factor, by host macrophages. In some cases, the cytokines may also be released by the tumor. The cytokines induce the synthesis of prostaglandins that act on the temperature regulation site of the hypothalamus, resulting in fever.

Unexpected weight loss

Like other malignant conditions, patients with Ewing sarcoma also experience weight loss. It may be due to multiple reasons. First, there is a loss of appetite in these patients, resulting in reduced nutritional uptake. Further, a tumor-induced hypermetabolic state also results in weight loss. The patients also lose weight during the treatment, as conventional treatment approaches, such as chemotherapy and radiation therapy, also result in diarrhea, loss of appetite, and vomiting.

Broken bones

Patients with Ewing sarcoma also have an increased risk of fracture. It is due to reduced bone strength because of the development and progression of the tumor. It has been reported that approximately one-third of the children with Ewing sarcoma of the femur had fractures during disease progression. Some studies reported no negative prognosis with pathological fractures in patients with Ewing sarcoma.

What are the Ewing Sarcoma Causes?

Chromosomal changes in a cell's DNA

The Ewing sarcoma causes are not known. However, it is believed that, like other cancers, Ewing sarcoma also occurs due to gene mutations. There are two types of genes present in the cell. One is the tumor suppressor gene that controls cell division and repairs any defect in DNA, while the other is the oncogene, which is responsible for cell division and growth. Due to certain factors, the tumor suppressor gene is turned off, or the oncogene is turned on, resulting in malignant conditions. It is believed that genetic changes in the genes are not inherited; rather, they occur during the child's life.

An alteration in the EWSR1 gene causes Ewing sarcoma. This gene is present on chromosome 22. The mutation is done through translocation. During translocation, a piece of chromosome 11, chromosome 21, or another chromosome is translocated on chromosome 22, resulting in turning on the EWSR1 gene.

Conclusion

There are several Ewing sarcoma symptoms. However, these symptoms overlap with those of other conditions, making the Ewing sarcoma diagnosis difficult. Ewing sarcoma symptoms include fatigue, fever, bone pain, pathological fracture, unexplained weight loss, swelling at the site of the tumor, and a lump. The Ewing sarcoma cause is not known. However, it is believed to be due to a mutation in the gene controlling cell growth and division.

Frequently Asked Questions

What does Ewing's sarcoma pain feel like?

Pain is not usually an early symptom of Ewing sarcoma. As the disease progresses, patients experience intermittent pain, particularly at night or during exercise. However, in advanced conditions, persistent pain is one of the signs of Ewing sarcoma. Patients may also experience severe, intense pain due to a tumor-induced pathological fracture.

Sarcoma is a malignant condition that begins in the connective tissues, such as cartilage, bones, and muscles. It occurs due to a mutation in the gene controlling the growth and division of the cells.

The common sites for developing Ewing sarcoma are the hands, feet, arms, pelvis, legs, chest, skull, and spine.

Ewing sarcoma affects the bones in several places, such as the pelvis, chest wall, legs, hand, spine, and skull. Apart from the bones, Ewing sarcoma also affects the cartilage and nerves.

In many patients, Ewing sarcoma may not cause any pain, especially during the early stages of the disease.