Ewing Sarcoma Clinical Presentation

Updated: Mar 03, 2021
  • Author: Jeffrey A Toretsky, MD; Chief Editor: Vikramjit S Kanwar, MBBS, MBA, MRCP(UK)  more...
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History and Physical Examination


Patient history includes the following:

  • Patients usually present with pain

  • Patients often have a palpable mass

  • Back pain may indicate a paraspinal, retroperitoneal, or deep pelvic tumor

  • Systemic symptoms of fever and weight loss can also occur and often indicate metastatic disease

Physical examination

Ewing sarcoma can occur in virtually any location. Careful examination of painful sites with inspection and palpation is critical.

Because patients can present with disease close to bone, tumors can result in neuropathic pain. Therefore, a comprehensive neurologic examination to evaluate asymmetrical weakness, numbness, or pain is critical. Patients with lesions of the long bones can present with a pathologic fracture

Clinically significant bone marrow metastases can result in petechiae or purpura due to thrombocytopenia, while patients with lung metastases can present with asymmetrical breath sounds, pleural signs, or rales.