Osteosarcoma and Ewing sarcoma are two types of bone cancer primarily affecting children and young adults. While both types of cancer originate in bone tissue, their symptoms, treatment, and location in the body differ.

Understanding the differences between osteosarcoma and Ewing sarcoma is crucial for proper diagnosis and treatment. The differences between them involve not only the location of where it begins but also the typical age when it occurs. Treatment often involves surgical removal of the tumor and chemotherapy.

This article explores the key characteristics of osteosarcoma and Ewing sarcoma and discusses the importance of distinguishing between them.

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There are several essential differences between osteosarcoma and Ewing sarcoma.

Osteosarcoma usually originates in the long bones of the arms or legs. In contrast, Ewing sarcoma commonly affects the:

  • pelvis
  • ribs
  • spine
  • long bones

It can also present as a rare form called extraosseous Ewing sarcoma, which originates in the muscles and soft tissues.

The age of onset also differs. Osteosarcoma typically occurs in individuals between 10 and 30 years of age and over 60 years of age. Ewing sarcoma is more common in children and adolescents, with a peak incidence between the ages of 10–15.

While both types of cancer are rare, osteosarcoma is the most common type of bone cancer, while Ewing sarcoma is less common.

Read more about bone cancer.

Osteosarcoma and Ewing sarcoma share some similar symptoms, including bone pain and swelling.

The primary symptom of osteosarcoma is intermittent pain that becomes persistent over time. It can also cause swelling, tenderness, and a lump near the tumor.

The disease can also lead to bone fractures near the tumor, along with a reduced range of motion in the affected joint and limping if the tumor is in the pelvic or leg.

If the tumor metastasizes, or spreads, to other locations, additional symptoms may arise, though this is rare.

Ewing sarcoma often causes pain, tenderness, and swelling near the tumor. The pain may initially come and go before eventually becoming consistent. People with Ewing sarcoma may also experience:

  • weakness
  • numbness
  • fever
  • lack of energy
  • weight loss
  • anemia, which involves low red blood cells
  • leukocytosis, which involves increased white blood cells

Diagnosing osteosarcoma and Ewing sarcoma usually involves a combination of imaging tests, such as X-rays, CT scans, and MRI scans, and a biopsy of the affected bone or tissue. Blood tests can also aid diagnosis by identifying specific tumor markers.

In some cases, distinguishing between osteosarcoma and Ewing sarcoma may require genetic testing or analyzing of tumor tissue. Proper diagnosis is important for determining the appropriate treatment approach and improving the chances of a favorable outcome.

To diagnose osteosarcoma, a healthcare professional will inquire about a person’s symptoms and medical history before ordering an X-ray. Osteosarcoma may show up as a starburst-shaped new bone formation, white-cloudy mass, and Codman triangle, which involves the outer bone layer elevating from the surface.

A healthcare professional may use an MRI scan to view bone marrow and additional soft tissues in detail, which helps identify the extent of the tumor and determine if it has metastasized to other areas.

If a tumor metastasizes, this means it spreads to other areas of the body from where it originally formed.

A CT scan can be a useful aid for further evaluation. However, a healthcare professional will typically only order this test for individuals who cannot have an MRI.

Following a discussion of symptoms and a physical exam, a healthcare professional may use the following imaging tests to diagnose Ewing sarcoma:

  • X-rays
  • MRI scans
  • CT scans
  • bone scans

They will also typically perform a biopsy to confirm the tumor is Ewing sarcoma.

After identifying the tumor as Ewing sarcoma, a healthcare professional will undergo a staging process that involves performing further tests to find out if the cancer has metastasized. Determining the stage of the tumor can help them create the most effective treatment plan.

The outlook for people with osteosarcoma depends on various factors, including:

  • age
  • overall health
  • coexisting medical conditions
  • the tumor stage and grade
  • blood alkaline phosphatase level at diagnosis
  • whether doctors can remove the tumor during surgery
  • the tumor’s response to chemotherapy

According to the American Cancer Society (ACS), the 5-year relative survival rates for osteosarcoma are:

  • localized, which means it has not spread: 76%
  • regional, which means it has spread to nearby structures: 64%
  • distant, which means it has spread to other areas of the body: 24%
  • overall survival rate: 59%

A relative survival rate helps give an idea of how long a person with a particular

condition will live after receiving a diagnosis compared with those without the condition.

For example, if the 5-year relative survival rate is 70%, it means that a person with the

condition is 70% as likely to live for 5 years as someone without the condition.

It is important to remember that these figures are estimates. A person can consult a

healthcare professional about how their condition is going to affect them.

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The outlook for people with Ewing sarcoma depends on various factors, including their age, overall health, and sage of the tumor. The overall 5-year relative survival rate for Ewing sarcoma is more than 70%.

Factors that increase the likelihood of survival include:

  • whether the cancer has metastasized
  • a positive response to chemotherapy
  • tumor location in the arms and legs rather than the pelvis
  • total removal of the tumor

Follow-up care is essential to detect late side effects of treatment and tumor recurrence. Typically, the reoccurrence of tumors happens within the initial few years after treatment.

Osteosarcoma and Ewing sarcoma are two types of bone cancer that can cause a range of symptoms, including pain and swelling. Various imaging technologies, such as X-rays, CT scans, and MRI scans, can diagnose both conditions.

The outlook depends on various factors, including age, overall health, and tumor response to treatment. However, early detection and treatment can significantly improve the likelihood of positive outcomes.

A healthcare professional can help an individual create the most effective treatment plan according to their circumstances.