Ewing Sarcoma

Diagnosing Ewing Sarcoma

The team of specialists here at Sheba Medical Center works tirelessly to ensure that each patient is treated with top-notch care from the initial diagnosis of Ewing Sarcoma and all the way through follow-up. The multidisciplinary team consists of medical oncologists, pediatric oncologists, radiation oncologists, hematologists, and pathologists who are all involved in the diagnostic part of your child’s cancer care.

Our extensive facilities offer all testing and equipment necessary so that you can benefit from quick results and immediate action throughout each stage of diagnosis and treatment.

During your child’s diagnostic evaluation, we may perform the following procedures:


Complete blood count (CBC).

A CBC is a blood test that analyzes the count of red blood cells, white blood cells, and platelets in the blood. An abnormal CBC may indicate that the cancer has spread to the bone marrow.


Imaging tests

If your child has signs and symptoms of Ewing sarcoma, the doctor will order imaging tests of the area to help identify whether there is a tumor. Imaging tests that may be used include x-rays, computed tomography (CT) scans, magnetic resonance imaging (MRI) scans, ultrasound (US), positron emission tomography (PET) scans, and bone scans



The only way to confirm a Ewing sarcoma diagnosis is with a biopsy. During a biopsy, a sample of the tumor is removed and sent to a laboratory, where pathologists look at the sample and determine whether or not it is cancerous.


Bone marrow aspiration and biopsy.

These tests are used to check whether the cancer has spread to the bone marrow. A bone marrow aspiration involves taking a sample of liquid bone marrow with a long, thin needle. During a bone marrow biopsy, a small piece of bone and marrow are removed and sent to the lab for testing. These procedures are performed at the same time.



A sample of cells is treated with antibodies that only stick to proteins found on Ewing sarcoma tumor cells. A dye causes them to change color so that they can be seen under a microscope.


Chromosome tests.

In most cases, Ewing tumor cells exhibit chromosomal changes that can help doctors identify the cancer type and diagnose accurately.


Fluorescent in situ hybridization (FISH).

This laboratory test uses fluorescent dyes that attach to certain genes or chromosomes. It can pick up on small changes that are not seen in other kinds of testing.


Once a Ewing sarcoma diagnosis is made, doctors try to figure out how advanced the cancer is by determining whether it has spread, and if so, how much. Our specialists will gather all the information from the diagnostic tests, and perform further testing if necessary. Stages 1 through 4 are used to signify how advanced the cancer is, with stage 1 being the least advanced, and stage 4 indicating that the cancer has spread to other parts of the body.

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