Ewing sarcoma

What it is

Ewing sarcoma is a malignant bone tumor that arises from marrow, listed there with myeloma, and it carries t(11;22).

Age and site

Location is diaphysis, and age is 5 to 25. The case that carries it is a 15 years old girl, and another is a 15-year old male with right shoulder pain. So the shaft of the bone is where it sits, not the ends.

How it presents

Progressive localized bony pain, mostly at night, not relieved by anti-inflammatory medications, with fever and weight loss. On examination the skin overlying the bone swelling is tender and erythematous.

The 15-year old male case is the same picture told again: right shoulder pain for 1 month, 5 pounds lost within that same timeframe, and difficulty sleeping at night due to feeling warm and sweaty.

The important point is that this mimics the presentation of infection, and the DDx is osteomyelitis. Night pain, fever, weight loss and a hot tender swelling are what infection would give.