Ewing's sarcoma Types

Type of Ewing's sarcoma base on occur location and performance:

1. Long bone: central and marginal type.

a. central backbone: the most common for a typical X-ray position, lesions occurred in the backbone, often for the symmetry of, early involvement of the medullary cavity center was a small dot-like or patchy osteolytic destruction of the district, was rat-bite shaped appearance, clear boundaries, there is no bone sclerosis, minor changes at this time, but also the performance of early lesions. Progress with the course of disease, destruction of osteolytic lesion area gradually increased, significantly undermine the District expanded and emerged periosteal reaction, was "Onion"-like appearance. Fusiform expansion of the backbone was. About 50% of cases occur in the central lesion of bone needles vertical. The formation of a small number of patients can also be triangular periosteum. If conditions should be observed every one and a half months, from early lesions to typical performance of only 1-2 months. After the emergence of a typical example, if treatment is delayed, it is still rapid expansion of lesions along the long axis of the wide spread of bone by osteolytic destruction of the inside out quickly up the backbone of 1 / 3 more than the last may be only one thin expansion of the periosteal new bone around the package, and sometimes the shell layer can be destroyed. Early invasive tumors of soft tissue can be formed is not clear or diffuse swelling mass.

b. cortical backbone: the characteristics of the outer cortical damage in varying degrees, generally smaller, sometimes were lobulated, and often the inner cortical bone intact. Often a large soft tissue mass, and bone out of proportion to the disease. Also into a layer of periosteal proliferation or the formation of radial bone needles. This type rarely seen in more central.

C. central metaphysis: Less. Most of the performance is similar to the backbone of central type, the difference is that different parts of the bone at the same time also the phenomenon of bone sclerosis.

D. marginal metaphysis: more rare. Metaphyseal lesions tend to side, showing osteolytic destruction and osteolysis can be shown similar to osteosarcoma. Epiphysis may also have been violated at the same time, resulting in bone destruction, known as dry-type epiphyseal epiphysis.

2. Other bone:

a. ribs: rib lesion was dissolved collapse of the limitations of destruction, at the same time within the spherical mass protruding into the chest. A small number of patients may have layered periosteal proliferation.

b. pelvis, scapula: were round or oval-shaped bone destruction can be manifested as patchy or bubble-like damage, or hardening showed hyperplasia. Lesions can also occur in the destruction of bone tumors flocculence, some cases can be spotted a small amount of calcification. Some may be layered periosteal reaction or the formation of radial bone needles. Often accompanied by soft tissue mass.

c. spine: the lesion is located in the spine, causing a wide range of vertebral bone destruction, often involving the vertebral body quickly of all, the destruction of spinal tuberculosis than the more obvious, but often the destruction of vertebral asymmetry and changes caused by wedge-shaped, lead to angular deformity of the spine. As the lesions progress, the annex or in the vicinity of the vertebral body is often disrupted. Often without periosteal reaction. More to maintain normal intervertebral space. The tumor is located in the spine may be paravertebral soft tissue shadow with tuberculosis is similar to the cold abscess. Tumor adjacent to lumbar muscles, the psoas major muscle may also apply to the infiltration, the formation of lumbar muscle swelling.