The Role of the Pediatric Surgeon in Bone Tumors: Thoracic Ewing Sarcoma and Osteosarcomas

Pediatric orthopedic oncology is a subspecialty within the discipline of pediatric orthopedics that is in the process of developing. Orthopedic oncology has traditionally focused on skeletally mature individuals, and research tends to be comprehensive rather than genuinely evaluating isolated populations. In pediatric population, the most common bone tumors are osteosarcoma and Ewing sarcoma. Osteosarcoma is a rare tumor that demands a multidisciplinary approach; standard treatment consists of multi-agent induction chemotherapy, surgical resection for local tumor control, and consolidation of local control at metastatic sites. Radiotherapy is reserved for cases with a marginal or incomplete resection or as a definitive treatment for unresectable disease. Ewing sarcoma is a rare tumor that necessitates a multidisciplinary approach to treatment. Multi-agent induction chemotherapy is followed by local treatment with surgery, definitive radiation, or a combination of surgery and radiation, followed by additional chemotherapy and consolidation local treatment to metastatic sites.