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05 Tibia: Ewing sarcoma

05 Pathology specimen
Age/sex: 18-year-old male
Size: 16.4 x 11.5 x 5.5 cm
The upper part of the tibia is expanded and partly destroyed by a white (focally brown because of bleeding) tumor that has extended outside the bone cortex into the adjacent soft tissue (arrow). This was an amputation specimen from an 18-year-old boy who died from metastatic disease less than one year after the surgery.


Ewing sarcoma

This is a rare form of cancer that usually affects individuals between 10 and 20 years of age. It typically arises in bone or soft tissue of the thigh, upper arm, or pelvis. Although not hereditary, there is a strong genetic influence in its development: 80 to 90 % of patients have a DNA translocation between chromosomes 11 and 22. Signs and symptoms include bone pain, soft tissue swelling, and fever. Treatment includes surgical excision of the tumor (sometimes amputation), chemotherapy and radiotherapy. Although recurrence is not uncommon following therapy, about 50% patients have long-term survival.

James Ewing (1866 – 1943) was an American pathologist who had a particular interest in cancer. He helped found both the American Association for Cancer Research (1907) and the American Cancer Society (1913). He also published one of the most widely used textbooks on the pathology of cancer in 1919. He was featured on the cover of Time magazine as “Cancer Man Ewing” on Jan 12, 1931. The article describing the clinical and pathological features of the tumor that bears his name was published in 1921.

Below: A portrait of James Ewing, drawn by Rebecca Lindon Taylor in 1930.

Source: Taylor, RL. (1930). Portrait of James Ewing. Wellcome Collection.

Portrai Dr. Ewing

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