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Childhood Ewing's Sarcoma Diagnosis

An accurate and comprehensive diagnosis of Ewing’s sarcoma is essential to successful treatment. At MD Anderson’s Children’s Cancer Hospital, our specialized pediatric sarcoma team – including dedicated surgeons, oncologists and pathologists – has incredible expertise and experience in pinpointing this type of cancer in children.

A definitive diagnosis of Ewing’s sarcoma begins with a biopsy of the tumor. If at all possible, this first biopsy should be at the cancer center where your child will receive treatment.

Diagnostic Tests

If your child has symptoms that may signal Ewing’s sarcoma, the doctor will examine your child and ask you questions about your child’s health and your family medical history.

One or more of the following tests may be done to find out if your child has Ewing’s sarcoma and if it has spread. They also may be done to find out if treatment is helping.

Biopsy: A biopsy, which removes a tiny piece of bone or soft tissue, is always needed to diagnose Ewing’s sarcoma. This is the only way to find out for certain if the tumor is cancer or another bone or soft tissue disease. It is very important for the biopsy to be done by someone with experience in diagnosing and treating Ewing’s sarcoma.

There are two types of bone biopsy:

Needle biopsy: A large, hollow needle is inserted through the skin to the area of bone or soft tissue to be tested. The needle removes a cylindrical sample of tissue to look at under a microscope. CT (computed tomography) scans may be used to help guide the needle.

Open or surgical biopsy: An incision (cut) is made, and the surgeon removes a tiny piece of the tumor to examine with a microscope. Rarely, the entire tumor may be removed.

Your child’s doctor will decide which type of biopsy is best based on several factors, including the type and location of the tumor. If possible, the surgeon who performs the biopsy should do the surgery to remove the cancer.

Imaging tests may be used before or after biopsy to pinpoint the location of the tumor and find out if it has spread. They may include:

  • CT or CAT (computed axial tomography) scans
  • MRI (magnetic resonance imaging) scans
  • PET (positron emission tomography) scans
  • X-rays
  • Bone scan

Bone marrow aspiration and biopsy

Genetic tests

Blood tests

Why Choose MD Anderson?

  • Extensive expertise in pediatric Ewing's sarcoma
  • Latest diagnostic tools, specialized pathologists
  • Advanced sarcoma surgical procedures, including limb-sparing surgery
  • Most advanced chemotherapy agents and delivery methods
  • Clinical trials of new sarcoma therapies
  • Family-centered care, including comprehensive support services

Ewing's Sarcoma Knowledge Center

Treatment at MD Anderson

Childhood Ewing's sarcoma is treated in our: 

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Getting a Second Opinion at MD Anderson

The experts at Children’s Cancer Hospital are highly specialized in diagnosing and staging Ewing’s sarcoma. We welcome the opportunity to provide second opinions.

If you would like to get a second opinion at MD Anderson, call 1-877-632-6789 to make an appointment or request an appointment online.


© 2014 The University of Texas MD Anderson Cancer Center