Summary
Ewing's sarcoma occurs in every bone of the foot. About one-third are located in the hindfoot, and 20% of the total occur in the calcaneous.
Complete Information on this Tumor
Ewing's sarcoma occurs in every bone of the foot. About one-third are located in the hindfoot, and 20% of the total occur in the calcaneous. Ewing's of the foot is a highly aggressive tumor with frequent metastasis. A complete cancer staging work-up is required and a carefully planned biopsy should be the last step in the sequence.
Patients normally have pain accompanied by significant diffuse swelling. The area may appear inflamed and a misdiagnosis of infection can be made. The white blood cell count, erythrocyte sedimentation rate and temperature may all be moderately elevated.
Patients have symptoms for an average of 14 months prior to diagnosis. Patients with hindfoot lesions have an average duration of symptoms of 22 months prior to diagnosis, whereas those with forefoot lesions have an average duration of symptoms of seven months.
Bone scan shows abnormal uptake, which may be intense. CT scan demonstrates the permeative destruction well. MRI is essential for surgical planning and demonstrates the soft tissue extent of the mass, which may be characteristically extensive.