Doctors Called It a Sports Injury — It Turned Out to Be a Rare Childhood Cancer

A 14-year-old Kirtland, Ohio, teen Evan Lallo has overcome Ewing sarcoma, a rare and aggressive form of bone cancer, after doctors first mistook his persistent shoulder pain for a sports injury. His case illustrated a recurring challenge in pediatric oncology: diagnostic delays due to symptoms that resemble common injuries.

The teenager’s parents said the pain did not improve with rest or initial treatment. Advanced imaging and a biopsy later revealed the presence of a malignant tumor. He went through months of chemotherapy, radiation, and surgery before doctors declared him cancer-free.

To celebrate his remission, Evan rang the “Bravery Bell” at Cleveland Clinic, a tradition for cancer patients completing treatment. He later threw the ceremonial first pitch at a Cleveland Guardians baseball game, where he was surprised by the chance to meet his favorite player, Josh Naylor.

Medical researchers note that Ewing sarcoma often presents with bone pain, swelling, or fever, which can be mistaken for minor trauma. A study in the Journal of Bone Oncology reported that up to 30 percent of young patients face delayed diagnosis, significantly lowering survival chances.¹

The American Cancer Society estimates that children diagnosed before the cancer spreads have a five-year survival rate of nearly 70 percent, but survival drops below 30 percent once the disease metastasizes. ² “Every delay matters,” researchers at Nottingham University said, urging physicians to investigate persistent or unexplained pain more thoroughly. ³

Despite the risks, experts say survival rates can improve with multimodal treatment that combines chemotherapy, surgery, and radiation. International trials such as EICESS-92 have shown that patients treated at specialized, high-volume centers achieve better results.

Emerging therapies, including targeted drugs and immunotherapies, are also showing promise in clinical trials for recurrent or resistant disease.

Oncologists who treated the boy emphasized that his recovery should remind families and healthcare providers to seek second opinions when symptoms persist. “Persistent pain in children should not be dismissed as a sports injury,” one doctor said.

References:

1. Patrick J. Leavey and Richard B. Womer. “Challenges of Diagnosing Ewing Sarcoma in Children and Adolescents.” Journal of Bone Oncology 16 (2019): 100237. https://doi.org/10.1016/j.jbo.2019.100237.

2. American Cancer Society. “Survival Rates for Ewing Tumors.” 2023. https://www.cancer.org/cancer/types/ewing-tumor/detection-diagnosis-staging/survival-rates.html.

3. Jeremy Whelan et al. “Delayed Diagnosis and Survival in Ewing Sarcoma: Findings from a UK Population-Based Study.” British Journal of Cancer 118 (2018): 742–748. https://doi.org/10.1038/bjc.2017.492.

4. Sameer Bakhshi et al. “Real-World Data of Ewing Sarcoma from a Resource-Limited Setting with Poor Compliance to Treatment Leading to Poor Outcomes.” ecancermedicalscience 15 (2021): 1185. https://doi.org/10.3332/ecancer.2021.1185.

5. Ruth Ladenstein et al. “Ewing Sarcoma: Current Management and Future Perspectives.” Clinical Sarcoma Research 8, no. 4 (2018). https://doi.org/10.1186/s13569-018-0093-y.

(Rh/Eth/ARC/MSM)