Definition of soft tissue cancers; includes cancers that originate from all types of soft tissue structures, such as muscle, fat, connective tissue, novelties, nerves.
Sarcoma is a rare type of cancer caused by connective tissue. Connective tissue is a system that connects and supports tissues in the body. Sarcomas can occur in bones, muscles, tendons, nerves, cartilage, adipose tissue, or blood vessels. There are more than seventy types of sarcoma. Sarcomas are called “soft tissue sarcoma” if they occur in soft tissues, or bone sarcoma or “osteosarcoma” if they occur in bones.
Sarcomas are more common in childhood. It is rare in adults. Sarcomas account for 15% of childhood cancers.
Sarcomas are more common in the arms and legs, abdomen and head and neck in order of frequency.
The most common symptoms are:
It is not known why sarcoma-type cancers occur. However, mutations in DNA are thought to be responsible for the development of sarcoma.
Hereditary syndromes: Some inherited diseases that pass through the family can increase the risk of sarcoma. Examples of this condition are retinoblastoma (tumor of the eye) and neurofibromatosis type 1.
Radiation therapy for cancer: Cancer patients undergoing radiation therapy may develop sarcoma later.
Lymphedema: A disease characterized by excessive swelling in the relevant area due to a disorder in the lymphatic system. Patients with lymph edema may develop angiosarcoma.
Chemicals: some industrial chemicals and pesticides may increase the risk of liver-borne sarcoma.
Viruses: The virus, called Human Herpes virus 8, can increase the risk of a sarcoma called Kaposi’s sarcoma in people with weakened immune systems.
Soft tissue sarcomas:
Angiosarcoma: this type affects blood or lymph vessels.
Gastrointestinal stromal tumor: This affects special neuromuscular cells of the intestine.
Liposarcoma: This is a adipose tissue sarcoma. These usually start on the thigh, behind the knee, or behind the abdomen.
Leiomyosarcoma: this is caused by smooth muscles in the organ walls. It usually occurs on the abdominal wall.
Synovial sarcoma: a tumor of stem cells. Cancerous tissue can develop around the joints.
Neurofibrosarcoma: This type affects the protective lining of nerves.
Rhabdomyosarcoma: Occurs in skeletal muscle.
Fibrosarcomas: These affect fibroblasts, which are cells in connective tissue.
Myxofibrosarcoma: Affects connective tissue and often develops in the arms and legs of older adults.
Mesenchymomas: These are rare and combine elements of other sarcomas. They can occur anywhere on the body.
Vascular sarcoma: This type occurs in blood vessels.
Schwannom: Affects the tissues lining the nerves.
Kaposi’s Sarcoma: This type mainly affects the skin, but can occur in other tissues. It is caused by Human Herpes Virus 8. It is a malignant tumor of the tissue that surrounds the lymph vessels in the skin. In Kaposi’s Sarcoma, tumors appear in the skin and internal organs. Tumors on the skin start as purple spots and eventually become fluffy from the skin. Kaposi’s Sarcoma can start in different regions at the same time. Herpes Virus 8 was detected in tumor examinations in patients. Kaposi’s sarcoma occurs especially in patients with immune system suppression due to AIDS and organ transplantation.
Kaposi sarcoma types:
Classical Kaposi sarcoma, Africa Kaposi sarcoma, Immunosuppression related Kaposi sarcoma, Epidemic Kaposi sarcoma, Non-epidemic Kaposi sarcoma. Lung film, endoscopy, skin biopsy and bronchoscopy can be performed for diagnosis.
Kaposi’s sarcoma spreads through lymph and blood. The course of the disease depends on the type and prevalence of cancer. Classic Kaposi’s sarcoma is more common in older men. In these patients, tumor placement is frequent in the feet and legs. Tumors grow slowly, brown-purple in color. It can spread to other organs over time. Radiation therapy, surgery, chemotherapy and biological treatments are applied according to the type and prevalence of the disease. Antiretroviral therapy is valuable in HIV-positive patients.
Osteosarcoma: the type of sarcoma that holds the bone is called osteosarcoma. It is common in children and adolescents. Osteosarcoma is the most common of malignant bone tumors in children. Patients 13 and 17 in osteosarcoma. mutations have been detected in his chromosome. Osteosarcoma often occurs in long bones. In most patients, the main symptom is pain. In half of cases, there is a mass that comes to the hand. In the area of involvement, movement restriction and weakness in the extremities (limbs) can be observed. It can metastasize by 15%. The most common metastases happen to the lungs, other bones, and brain.
Ewing Sarcoma: This can occur in bone or soft tissue. Ewing sarcoma often occurs between the ages of 5-20. A large mass of soft tissue and bone destruction are observed. On the body, it most often occurs in the arms and legs, pelvis and ribs.
Chondrocarcoma: This begins in the cartilage.
Fibrosarcoma: This occurs in fibrogenic tissue, a type of connective tissue.
If you have a mass in your body, your doctor may find the biopsy appropriate. A biopsy is of great importance for determining the type and staging of the tumor. A biopsy can be performed directly, under ultrasound or accompanied by tomography. Soft tissue sarcomas can best be viewed with MRI. Direct graph, tomography, PET, bone scan and ultrasound may be requested from the patient in cases where appropriate. In osteosarcoma, 50% of patients have high serum alkaline phosphate in the blood and 25% have high serum lactate dehydrogenase (LDH). Direct radiography makes a diagnosis. (In the radiographic image, there is a lytic and sclerotic lesion in the bone, where construction and destruction are together).
The most common treatment is surgery. The surgeon removes the tumor and surrounding tissue. It also takes samples to send to pathology. After surgery, radiotherapy can be applied. Radiation therapy is sometimes initially applied to shrink the tumor. If the patient is not suitable for surgery, only radiotherapy can be given. Chemotherapy can be used in combination with surgery or instead of surgery to treat sarcoma.
In targeted treatments that have been implemented in recent years, the body’s intact cells are protected and treated directly for the tumor. Immunotherapy is a drug treatment that uses the immune system to fight cancer. Ablation therapy is a treatment that destroys cancer cells by applying electricity to heat cells, too cold liquid to freeze cells, or high-frequency ultrasound waves to damage cells.
Sarcomas are divided into 4 stages according to the state of spread. In stages 1 and 2, the tumor is locational. In Stage 3, the tumor has spread to the lymph nodes in the area where it is located. In Stage 4, it metastasized to distant organs.
The clinical course of soft tissue cancer depends on the type, stage and location of sarcoma. According to statistical studies, the survival rate of 5 years after diagnosis is considered to be:
if sarcoma has not spread: 88%
if it has spread to nearby tissues:
58% if it has spread to distant organs: 16%.
5-year survival rate for osteosarcoma:
if the cancer has not spread: 77%
if it has spread to surrounding tissues:
65% if it has spread to distant organs: 27%.
Patient age and early diagnosis of the disease are two important factors that ensure high 5-year survival rates.
Some changes in soft tissues are caused by inflammation or injury and can form a mass that resembles a soft tissue tumor. Unlike a true tumor, they do not come from a single abnormal cell, their ability to grow or spread to nearby tissues is limited, and they never spread from the bloodstream or lymphatic system to other parts of the body.
A team of orthopedists, surgeons, medical oncologists, radiation oncologists and pathologists performs the treatment and follow-up of sarcoma, that is, soft tissue cancers. If you also have a person in your family who shows the symptoms mentioned above, you can contact the nearest medical facility or oncology center to evaluate treatment options.