[Ewing's sarcoma: literature review and presentation of 4 cases]

Ewing's sarcoma occurs most often in young males of caucasian type and affects the medio-diaphysis of a long bone of the lower extremity, the pelvis and the humerus. Radiologically there is bone destruction, onion skin appearance, a Codman triangle and extension into the surrounding soft tissues. Microscopically, this tumor is composed of small round cells and it can be differentiated from non Hodgkin lymphoma, metastatic neuroblastoma and embryonal rhabdomyosarcoma. Recent immunological studies suspect a neuroectodermal origin. Ewing's sarcoma growths rapidly and spreads to lung and other bone locations. Without treatment, survival at 5 years is less than 5%. The actual therapeutic approach is multidisciplinary including surgery, chemotherapy and if necessary radiotherapy. With this approach actual survival rates at 5 years reaches 75%.