Initial Symptoms and Clinical Features in Osteosarcoma and Ewing Sarcoma*

Paraplegia: an unusual presentation of Ewing's sarcoma

“…Conversely, in more than 80% of cases, the pain was found to be intermittent, strain related, and not aggravated at night, as in benign musculoskeletal conditions. 6 In our case the pain was intermittent at the beginning, continuous and severe later in the course. Patients with severe pain may need opioids.…”

“…5 It has been stated that these tumors are so rare that most doctors will see only a few patients with symptoms from an undiagnosed primary bone tumor during their whole working life. 6 In our case the diagnosis was delayed 2 or 3 weeks because of poor medical follow-up. Total delay in diagnosis was 40 weeks.…”

“…Widhe et al reported a mean delay of 34 weeks (ranging from 3 to 150) in Ewing's sarcoma cases with di erent locations. 6 In their study, 12 out of 47 patients consulted a doctor more than six times before the tumor was diagnosed, and one patient had to see a Early diagnosis is of great importance in Ewing's sarcoma, because favorable results are reported with early treatment. 5 Nevertheless, several factors may delay the diagnosis.…”

“…6 Tendinitis and sciatica were found to be the most frequent misdiagnoses. Although a radiograph at the ®rst medical visit is believed to reduce the delay in diagnosis, misinterpretation of that radiograph as normal may lead to further delay.…”

“…Signs of spinal cord compression may be initial indicators for Ewing's sarcoma 8 ± 10 and trauma may be found in the patient's history in one quarter of the cases. 6 …”