Is the misdiagnosis rate of Ewing sarcoma high?

summary

Ewing's sarcoma of bone is a poorly differentiated malignant tumor with small round cells. It accounts for 6% - 8% of all primary bone tumors. It is the most common malignant primary bone tumor in children and adolescents. Pain and swelling are the most common early symptoms, followed by nerve root and spinal cord injury, some patients with low fever, serum high density lipoprotein cholesterol and erythrocyte sedimentation rate increased significantly, sometimes accompanied by increased white blood cell count and anemia. The lesions may produce large soft tissue masses.

Is the misdiagnosis rate of Ewing sarcoma high?

Pain is the most common clinical symptom. About 2 / 3 of the patients may have intermittent pain. The degree of pain was different, and it was not serious at the beginning, but it quickly became persistent pain; According to the location, local pain will spread with the spread of the tumor. If it occurs in the pelvis, the pain can radiate along the lower limbs and affect the activity of the hip joint; If it occurs in the long bone near the joint, there will be lameness, joint stiffness, and joint effusion. This tumor is rarely associated with pathological fractures, located in the spine. Can produce lower limb radiation pain, weakness and numbness.

With the aggravation of pain, local mass appeared. The mass grew rapidly. The surface of the mass showed inflammation of red, swelling, heat and pain. The tenderness was significant. The surface of the mass could have venous distention. Sometimes the mass grew very fast in soft tissue, and it could grow head by head in 2-3 months. For tumors occurring in the iliac bone, the mass can extend into the pelvic cavity and can be touched in the lower abdomen or anus.

Patients with systemic symptoms are often accompanied by systemic symptoms, such as body temperature up to 38 ℃ - 40 ℃, body discomfort, fatigue, loss of appetite and anemia. In addition, the location of the tumor is different, but also can cause other symptoms, such as lesions located in the lower femur, can affect the function of the knee joint, and cause repeated joint effusion; Lesions in the ribs can cause pleural effusion.

matters needing attention

The younger the age of onset, the worse the prognosis. Most scholars believe that the prognosis is not closely related to the patient's age and gender, and the tumor location is an important factor affecting the prognosis. The prognosis of patients with primary tumors in the limbs is better than that in the pelvis, sacrum and other trunk positions. As far as limb tumors are concerned, those located in the distal side of the limb are better than those in the proximal side.