If you or your child has symptoms of Ewing sarcoma, you’ll need certain exams and tests to be sure. Diagnosing Ewing sarcoma starts with your healthcare provider asking questions. He or she will ask you about health history, symptoms, risk factors, and family history of disease. The healthcare provider will also do a physical exam.
What tests might be needed?
You or your child may need 1 or more of the following tests:
Imaging tests are the first things done if the healthcare provider thinks you may have a bone tumor, like Ewing sarcoma.
X-rays of the bone
This is often the first test done. An X-ray uses very low doses of radiation to get pictures of your bones and organs. It imprints an image of the inside of your body onto a piece of film. Healthcare providers can see most bone tumors on an X-ray, and may even be able to tell if it's likely a Ewing sarcoma.
This test uses magnets and radio waves to take detailed pictures of the inside of your body. An MRI is often the next test done if an X-ray shows something suspicious. It can more clearly define changed areas to see if the problem is a Ewing tumor or if it's some other bone damage or an infection. MRI can show details of the tissue around the tumor, as well as the inside of the bone with the tumor.
The results of imaging tests might suggest a bone tumor. But the only way to be sure is by taking out a piece of the changed bone and looking at it under a microscope. This is called a biopsy. There are different ways to get a bone biopsy. It’s important that the doctor doing the biopsy is working with a healthcare provider who has experience in treating Ewing sarcoma. This is to be sure that the way the skin is cut or the piece of tumor is taken out does not affect later treatment with radiation or surgery.
For this type of bone biopsy, your healthcare provider uses a large, hollow needle. . He or she puts it through your skin and into the bone tumor to get a tiny piece of it. This type of biopsy doesn’t require surgery. In most cases, you’re awake for it, but the area is made numb. Your healthcare provider may use a CT scan to help guide the needle into the right place.
If the tumor is large, a healthcare provider might rake out a small part of it through a cut (incision) in your skin. If the tumor is close to your skin, you may be given medicines make you sleepy. The surgeon will numb the area to do the biopsy. If the tumor is deep inside your body, you may need general anesthesia. In this case, medicines are used to put you into a deep sleep so you don't feel pain while the biopsy is done.
If the tumor is small, a surgeon might cut through your skin and take out (excise) the whole tumor. This type of surgery usually requires general anesthesia This means you’ll be in a deep sleep.
Getting your test results
When your health care provider has the results of the tests, he or she will contact you. Your provider will talk with you about other tests that may be needed if Ewing sarcoma is found. Make sure you understand the results and what needs to be done next.