What is Ewing's sarcoma?

This information has been written for patients, their families and friends and the general public to help you understand more about Ewing's sarcoma: what it is and the different types. This information is produced in accordance with BCRT's information policy.

Ewing's sarcoma is a 'primary bone cancer'

Ewing's sarcoma is a rare cancer that can form in bone and soft tissue. It belongs to a group of tumours known as the Ewing's Sarcoma Family of Tumours.

The Ewing's family of tumours includes:

The majority of Ewing's sarcomas (around 85%) start in the bones, but they can also start in the soft tissues as well.

Ewing's sarcomas is the second most commonly diagnosed primary bone cancer in young people, after osteosarcoma. Ewing's sarcoma can start anywhere in body, but more often it is found in the pelvis, the chest or in the bones of the legs, see figure 1.

Figure 1. Where does Ewing's Sarcoma occur most often?

Image by Hannah Thompson

Ewing's sarcoma and osteosarcoma occur in slightly different places in the skeleton. Osteosarcoma usually starts in the ends of the bone, and less often in the middle (shaft) of the bone.

Ewing's sarcoma arises from any point in the bone with almost equal frequency. Ewing's sarcoma is more commonly found in flat bones (e.g. the ribs or the pelvis) than osteosarcoma.

Figure 2. What are the different parts of a long bone?

Image by Hannah Thompson  
Ewing's sarcoma can spread to other parts of the body

Ewing's sarcoma can quickly spread to other parts of the body and can sometimes come back after treatment (recur), and so patients require treatment to the whole body (systemic) as well as the site of the primary tumour.

Tumour cells can break away from the primary tumour and enter the blood supply or lymphatic (lim-FAT-ick) system. These tumour cells can travel to other parts of the body where they can settle and form new tumours called secondary tumours or metastases (met-AS-tasees). The tumour cells can also spread through the bone as the tumour grows.

The most common sites for secondary tumours are:

Very rarely the cancer can spread to the lymph (lim-FF) nodes, liver or brain.

Treatment is usually a combination of chemotherapy, surgery and radiotherapy. Wherever in the body Ewing's sarcoma starts, the treatment is the same (this is covered in more detail in the How is Ewing's sarcoma treated? section.

Ewing's sarcoma information Version 2, June 2013
Last reviewed: June 2013
Next review due: June 2015

The authors and reviewers of this information are committed to producing reliable, accurate and up to date content reflecting the best available research evidence, and best clinical practice. We aim to provide unbiased information free from any commercial conflicts of interest. This article is for information only and should not be used for the diagnosis or treatment of medical conditions. BCRT can answer questions about primary bone cancers, including treatments and research but we are unable to offer specific advice about individual patients. If you are worried about any symptoms please consult your doctor.

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