Diagnosis
If a person has any symptoms of Ewing's sarcoma, a doctor should conduct a physical examination and take a full medical history. If the doctor still suspects Ewing's sarcoma, he or she may recommend any of the following procedures. X-rays and other imaging tests are usually ordered first to detect the location and presence of the tumor. If the doctor still thinks an Ewing's sarcoma is a possibility, he or she will then perform a biopsy to get a definitive diagnosis.
Biopsy
A biopsy is the only way to know for sure if a bone tumor is Ewing's sarcoma. A doctor will remove a small sample of bone and have it examined under a microscope for cancer cells.
Click Image to Enlarge
Surgical Biopsy
The doctor uses a surgical knife to make an incision and remove a sample of bone tissue. The doctor sends this sample to a laboratory to be examined under a microscope for cancer cells.
Click Image to Enlarge
Needle Biopsy
The doctor uses a long needle to remove a tissue sample from the bone. The doctor sends this sample to a laboratory to be examined under a microscope for cancer cells.
Imaging Tests
The doctor may recommend the following imaging tests to help better determine the tumor's location, size and extent:
X-Ray
X-rays use electromagnetic radiation to produce images of the inside of the body. Doctors can often see the size, shape, and location of bone tumors on regular X-rays. X-rays may help the doctor determine if the tumor is likely to be an Ewing's sarcoma; however, a biopsy is always needed for an accurate diagnosis.
Click Image to Enlarge.
Computed Tomography (CT) Scan
A computed tomography (CT) scan uses X-rays to produce an image of your body. A special dye may be injected into your veins and you may be asked to drink a special fluid in order to make the internal organs stand out. A CT scan produces detailed images of the soft tissues of the body, and can help a doctor determine if an Ewing's sarcoma has grown into nearby tissues such as fat, muscles or tendons.
Click Image to Enlarge.
Magnetic Resonance Imaging (MRI) Scan
MRI scans use radio waves and a strong magnet to create clear and detailed images of body parts. Radio waves are absorbed by the body and then released in a certain pattern, which is translated by a computer in order to show “slices” of the body. If the doctor notices an abnormality on an X-ray, he or she may order an MRI to inspect it more closely. MRIs show the bone in much more detail than plain X-rays and can help doctors better determine the extent of the cancer.
Click Image to Enlarge.
Positron Emission Tomography (PET) Scan
For a PET scan, the doctor injects a radioactive substance into the patient's bloodstream. This substance collects in malignant (cancerous) cells in the patient's body. The doctor then uses a PET scanner to detect these areas of radioactivity and to find the exact location of cancer in the patient's body.
Click Image to Enlarge.
Bone Scan
A bone scan uses a radioactive substance to identify cancerous tissues in the bones. A bone scan provides a picture of all of the bones in the body, and allows doctors to find small areas of cancer not seen on plain X-rays. The radioactive substance collects in these areas and illuminates them on the skeletal X-ray.
