Osteosarcoma and Ewing sarcoma represent the 2 most common cancers of bone seen in the pediatric population. Bone cancers as a group represent approximately 4 of the approximately 10,000 new pediatric cancer diagnoses made each year in the United States. (1) As with many pediatric tumors, although some cases can be attributed to environmental factors (such as ionizing radiation) or inherited genetic risk, most cases are believed to arise spontaneously. The anatomical location of the tumors shows differences between Ewing sarcoma and osteosarcoma, and Ewing sarcoma can also present as soft tissue masses. Patients commonly present with pain or swelling, leading to the identification of a mass, by examination or imaging. Although treatment regimens differ between them, both sarcomas require therapy that includes both systemic chemotherapy and an element of local control, such as surgical resection or radiotherapy. For both sarcomas, survival decreases dramatically when the disease is determined to be metastatic, and the lungs are the most common site of metastases. In both cases, there are a variety of sequelae present in long-term survivors as a result of treatment or because of the location of the primary tumor, requiring special attention in survivorship care.
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