## Core Concept
Ewing's sarcoma is a type of malignant bone tumor that primarily affects children and young adults. It is characterized by its aggressive nature and tendency to metastasize. The tumor is believed to originate from primitive neuroectodermal cells.

## Why the Correct Answer is Right
Ewing's sarcoma is known for its specific genetic abnormality, the t(11;22) translocation, which results in the formation of the EWS-FLI1 fusion gene. This genetic anomaly plays a crucial role in the pathogenesis of the tumor. The tumor typically presents with systemic symptoms such as fever, weight loss, and elevated erythrocyte sedimentation rate (ESR), alongside local pain and swelling.

## Why Each Wrong Option is Incorrect
- **Option A:** Ewing's sarcoma often presents with a high ESR, which is indicative of an inflammatory response. This is a characteristic feature, making option A a true statement about Ewing's sarcoma.
- **Option B:** The presence of a specific chromosomal translocation, notably t(11;22), is a hallmark of Ewing's sarcoma. This makes option B a correct statement regarding the genetic underpinnings of the disease.
- **Option C:** Ewing's sarcoma is indeed aggressive and has a high potential for metastasis, particularly to the lungs and other bones. Therefore, option C is also a true statement about the clinical behavior of Ewing's sarcoma.

## Clinical Pearl / High-Yield Fact
A key clinical pearl for Ewing's sarcoma is that it often presents with systemic symptoms, which can mimic infection or inflammatory conditions, leading to delays in diagnosis. Early recognition and biopsy for histopathological and genetic analysis are critical for diagnosis.

## Correct Answer Line
**Correct Answer: D.**