A REVIEW AND CLASSIFICATION OF BONE SARCOMAS

JAMES EWING
1922 Archives of Surgery  
The knowledge of tumors of bone and bone marrow is still in the descriptive stage. To reach a correct histologic diagnosis of the case and to provide some conception of the probable clinical course are all that can be expected at the present time, and often more than is accomplished. The separation of the numerous tumors of this group into well-defined clinical and pathologic entities is far from complete, while knowledge of the exact origins of these tumors and of their various exciting and
more » ... ous exciting and contributing causative factors is extremely fragmentary, or, indeed, wholly lacking. Moreover, with the present trend of medical research, the prospects are not favorable to important progress in this field. Serology, immunology, chemistry, studies in nutrition, and the use of modern instruments of precision have contributed little and promise little in the study of bone tumors. Abundant clinical material, wide clinical experience, and knowledge of the embryology, physiology and pathology of bone, are the more essential qualifications for successful investigation in this field. Such studies call for clinical observation by the surgeon, and morphologic research by the pathologist, by each of whom the work must be carried out on a broad and systematic plan. The surgeon must provide complete clinical pictures of the different neoplastic diseases of bone; and the pathologist must discover the origin, the predisposing anatomic conditions, the mode of growth, and the general etiologic factors, if an effective knowledge of these diseases is to be attained. When this knowledge has been secured, it will still be neces¬ sary to devise means for its dissemination so that it may become effective in controlling the mortality and possibly the incidence of these diseases. For this purpose a uniform nomenclature is highly desirable or essential; and the main clinical and morphologic features of the dif¬ ferent bone tumors must be clearly presented in accessible form. The present article is intended as a contribution toward this end. classification of tumors of bone and bone marrow In the legitimate classification of tumors of bone only those neoplastic diseases which clinical experience shows to actually occur must be Downloaded From: http://archsurg.jamanetwork.com/ by a McMaster University User on 09/17/2015
doi:10.1001/archsurg.1922.01110120002001 fatcat:nqlhgtdyebespfqwzxnaidbz7q