eMedicine Specialties > Radiology > Musculoskeletal

Ewing Sarcoma: Follow-up

Author: Ludwig G Strauss, MD, Associate Director, Professor, Department of Innovative Cancer Diagnostics and Therapy, CCU Nuclear Medicine, German Cancer Research Center
Contributor Information and Disclosures

Updated: Feb 19, 2009

Intervention

Medicolegal Pitfalls

  • Because of the limited prognosis for Ewing sarcoma, a high diagnostic accuracy is important with the morphologic imaging methods, functional procedures, and histologic analyses.
  • In particular, differentiating Ewing sarcoma from osteomyelitis usually requires histologic confirmation.
  • Tumor spread must be recognized, and methods such as PET scanning with FDG and/or bone scanning can help in detecting metastases.
  • Furthermore, monitoring of therapeutic responses requires both morphologic imaging (to trace the tumor volume) and quantitative functional studies (to assess tumor vitality).
 


More on Ewing Sarcoma

Overview: Ewing Sarcoma
Imaging: Ewing Sarcoma
Follow-up: Ewing Sarcoma
Multimedia: Ewing Sarcoma
References
Further Reading
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References

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  2. Rogers LF. Bone tumors and related conditions. In: Juhl JH, Crummy AB, Paul L, eds. Paul and Juhl's Essentials of Radiologic Imaging. 5th ed. Philadelphia, Pa: Lippincott-Raven; 1987:85-384.

  3. Miser JS, Goldsby RE, Chen Z, et al. Treatment of metastatic Ewing sarcoma/primitive neuroectodermal tumor of bone: evaluation of increasing the dose intensity of chemotherapy. Report from the Children's Oncology Group. Pediatr Blood Cancer. Dec 2007;49(7):894-900. [Medline].

  4. Riggi N, Stamenkovic I. The biology of Ewing sarcoma. Cancer Lett. Aug 28 2007;254(1):1-10. [Medline].

  5. Verrill MW, Judson IR, Harmer CL, et al. Ewing's sarcoma and primitive neuroectodermal tumor in adults: are they different from Ewing's sarcoma and primitive neuroectodermal tumor in children?. J Clin Oncol. Jul 1997;15(7):2611-21. [Medline].

  6. Dehner LP. Peripheral and central primitive neuroectodermal tumors. A nosologic concept seeking a consensus. Arch Pathol Lab Med. Nov 1986;110(11):997-1005. [Medline].

  7. Sundaresan N, Rosen G, Boriani S. Primary malignant tumors of the spine. Orthop Clin North Am. Jan 2009;40(1):21-36. [Medline].

  8. Ordóñez JL, Martins AS, Osuna D, Madoz-Gúrpide J, de Alava E. Targeting sarcomas: therapeutic targets and their rational. Semin Diagn Pathol. Nov 2008;25(4):304-16. [Medline].

  9. Paulussen M, Ahrens S, Braun-Munzinger G, et al. [EICESS 92 (European Intergroup Cooperative Ewing's Sarcoma Study)-- preliminary results] [German]. Klin Padiatr. Jul-Aug 1999;211(4):276-83. [Medline].

  10. Damron TA, Ward WG, Stewart A. Osteosarcoma, chondrosarcoma, and Ewing's sarcoma: National Cancer Data Base Report. Clin Orthop Relat Res. Jun 2007;459:40-7. [Medline].

  11. Smorenburg CH, van Groeningen CJ, Meijer OW, Visser M, Boven E. Ewing's sarcoma and primitive neuroectodermal tumour in adults: single-centre experience in The Netherlands. Neth J Med. Apr 2007;65(4):132-6. [Medline]. [Full Text].

  12. Iwamoto Y. Diagnosis and treatment of Ewing's sarcoma. Jpn J Clin Oncol. Feb 2007;37(2):79-89. [Medline]. [Full Text].

  13. Lopes SL, Almeida SM, Costa AL, Zanardi VA, Cendes F. Imaging findings of Ewing's sarcoma in the mandible. J Oral Sci. Jun 2007;49(2):167-71. [Medline]. [Full Text].

  14. Rodríguez-Galindo C, Liu T, Krasin MJ, et al. Analysis of prognostic factors in ewing sarcoma family of tumors: review of St. Jude Children's Research Hospital studies. Cancer. Jul 15 2007;110(2):375-84. [Medline].

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  17. Bacci G, Ferrari S, Bertoni F, et al. Prognostic factors in nonmetastatic Ewing's sarcoma of bone treated with adjuvant chemotherapy: analysis of 359 patients at the Istituto Ortopedico Rizzoli. J Clin Oncol. Jan 2000;18(1):4-11. [Medline]. [Full Text].

  18. O'Sullivan P, O'Dwyer H, Flint J, Munk PL, Muller NL. Malignant chest wall neoplasms of bone and cartilage: a pictorial review of CT and MR findings. Br J Radiol. Aug 2007;80(956):678-84. [Medline].

  19. Erlemann R, Sciuk J, Bosse A, et al. Response of osteosarcoma and Ewing sarcoma to preoperative chemotherapy: assessment with dynamic and static MR imaging and skeletal scintigraphy. Radiology. Jun 1990;175(3):791-6. [Medline]. [Full Text].

  20. Zhang WD, Xie CM, Mo YX, Li JY. [CT and MRI features of peripheral primitive neuroectodermal tumor] [Chinese]. Ai Zheng. Jun 2007;26(6):643-6. [Medline].

  21. San-Julian M, Aquerreta JD, Benito A, Cañadell J. Indications for epiphyseal preservation in metaphyseal malignant bone tumors of children: relationship between image methods and histological findings. J Pediatr Orthop. Jul-Aug 1999;19(4):543-8. [Medline].

  22. Ekram T, Elsayes KM, Cohan RH, Francis IR. Computed tomography and magnetic resonance features of renal Ewing sarcoma. Acta Radiol. Nov 2008;49(9):1085-90. [Medline].

  23. Kleis M, Daldrup-Link H, Matthay K, Goldsby R, Lu Y, Schuster T, et al. Diagnostic value of PET/CT for the staging and restaging of pediatric tumors. Eur J Nucl Med Mol Imaging. Jan 2009;36(1):23-36. [Medline].

  24. Hayashida Y, Yakushiji T, Awai K, et al. Monitoring therapeutic responses of primary bone tumors by diffusion-weighted image: initial results. Eur Radiol. Dec 2006;16(12):2637-43. [Medline].

  25. Ozcan Z, Burak Z, Kumanlioglu K, et al. Assessment of chemotherapy-induced changes in bone sarcomas: clinical experience with 99Tcm-MDP three-phase dynamic bone scintigraphy. Nucl Med Commun. Jan 1999;20(1):41-8. [Medline].

  26. Shulkin BL, Mitchell DS, Ungar DR, et al. Neoplasms in a pediatric population: 2-[F-18]-fluoro-2-deoxy-D-glucose PET studies. Radiology. Feb 1995;194(2):495-500. [Medline]. [Full Text].

  27. Strauss LG, Koomaegi R, Dimitrakopoulou-Strauss A. Dynamic positron emission tomography (PET) with 18F-deoxyglucose (FDG) in bone tumors: correlation of quantitative PET and gene expression [abstract]. J Nucl Med. 2001;42:33P.

  28. Arush MW, Israel O, Postovsky S, et al. Positron emission tomography/computed tomography with (18)fluoro-deoxyglucose in the detection of local recurrence and distant metastases of pediatric sarcoma. Pediatr Blood Cancer. Dec 2007;49(7):901-5. [Medline].

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Keywords

Ewing sarcoma, Ewing's sarcoma, malignant primary bone tumor, red bone marrow tumor, Ewing tumor, neural tumor, peripheral primitive neuroectodermal tumor, PNET, Ewing family of tumors, EFTs, Ewing sarcoma family of tumors, ESFTs

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Contributor Information and Disclosures

Author

Ludwig G Strauss, MD, Associate Director, Professor, Department of Innovative Cancer Diagnostics and Therapy, CCU Nuclear Medicine, German Cancer Research Center
Ludwig G Strauss, MD is a member of the following medical societies: Society of Nuclear Medicine
Disclosure: Nothing to disclose.

Medical Editor

Amilcare Gentili, MD, Clinical Professor of Radiology, University of California at San Diego; Consulting Staff, Department of Radiology, Thornton Hospital
Amilcare Gentili, MD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

William R Reinus, MD, MBA, FACR, Professor of Radiology, Temple University; Chief of Musculoskeletal and Trauma Radiology, Vice Chair, Department of Radiology, Temple University Hospital
William R Reinus, MD, MBA, FACR is a member of the following medical societies: Alpha Omega Alpha, American College of Radiology, American Roentgen Ray Society, Radiological Society of North America, and Sigma Xi
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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