[Ewing sarcoma. Diagnostic and therapeutic problems in children].
A pathological X-ray of the skeleton with the clinical correlation "painful swelling of soft tissue" is always an alarming sign in childhood. Radiology is our most important device to decide if the disease is of traumatic, inflammatory, incretory or neoplasmatic as well as of degenerative origin. Considering the group of "neoplasmatic alterations" there are more than 50 different entities. The differential diagnosis of a "bone tumor" requires large experience from the radiologist. Supporting the oncologist an experienced pathologist must be capable to distinguish a reticulosarcoma, a neuroblastoma metastasis, a leukemic bone-infiltrate or an embryonal rhabdo-myosarcoma from an Ewing's sarcoma. An experienced surgeon is of the same importance capable of not only collecting detritus out of necrotic tumor centres or altered tissues, but of gathering several samples from vital tumor tissue. This experienced team is especially required when children are in concern, as this age represents the peak of manifestation of malignant bone-sarcoma as Ewing's sarcoma or osteosarcoma. The quoted case-descriptions point our how difficult it may be to find the proper biopsy location and how initial false diagnosis lets valuable time pass by and prevents early diagnosis.
D000293:Adolescent; D000328:Adult; D001706:Biopsy; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis; D011877:Radionuclide Imaging; D012512:Sarcoma, Ewing / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D013977:Tibia / Q000473:pathology; D014750:Vincristine / Q000627:therapeutic use
D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide
Ewing-Sarkom. Diagnostische und therapeutische Probleme im Kindesalter.