Patients commonly present with the following symptoms:
4. Pathologic fracture (16%).
It is important to realize that, because fever is a frequent symptom of Ewing sarcoma, it may be initially mistaken for osteomyelitis. The previous symptoms may be present for long periods of time, and more than 5% of patients have had symptoms for over 6 months before the tumor is identified. The pain may be intermittent.
Ewing sarcoma most commonly involves the lower extremity, with the pelvis being the next most common site. Table 21-6 lists the primary sites of origin in Ewing sarcoma. In long bones, Ewing sarcoma usually begins in the diaphysis.
Askin tumor is a PPNET of the thoracopulmonary region that involves the chest wall. It is seen more commonly in adolescent women. It is thought to arise from pluripotent cells along the intercostal nerves.
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