sarcoma

What is Sarcoma?

Sarcoma is a rare type of cancer that begins in the bones and soft (connective) tissues, including fat, muscles, blood vessels, nerves, deep skin tissues, and fibrous tissues [1]. It is a broad group of cancers that can develop in various parts of the body.

Types of Sarcoma

There are two main types of sarcoma: soft tissue sarcoma and osteosarcoma. Soft tissue sarcoma refers to cancers that start in soft tissues such as muscles, tendons, fat, lymph vessels, blood vessels, and nerves [5]. Osteosarcoma, on the other hand, is a type of sarcoma that develops in bones.

Characteristics of Sarcoma

Sarcomas are rare cancers that can develop from bones or soft tissues. They can be found nearly anywhere in the body, including the arms, legs, chest, abdomen, and pelvis [6]. Because bone and soft tissues can be found almost everywhere in the body, sarcomas can also occur in various locations.

Definition of Sarcoma

A sarcoma is a rare kind of cancer that forms tumors in connective tissues, such as bones, muscles, blood vessels, cartilage, fat, ligaments, lymph vessels, and nerves [4]. It is a type of malignant tumor that arises from connective tissue (bone or muscle etc.) [9].

References:

[1] Dec 28, 2022 — Sarcoma is the general term for a broad group of cancers that begin in the bones and in the soft (also called connective) tissues...

[4] Sarcoma is a rare type of cancer that forms tumors in connective tissues, such as bones, muscles, blood vessels, cartilage, fat, ligaments, lymph vessels, ...

[5] A sarcoma is a rare kind of cancer. The type depends on the body tissue it affects. Main types include soft tissue sarcoma and osteosarcoma.

[6] Sarcomas are cancers that develop from bones or soft tissues, such as fat, muscles, nerves, and more. Because bone and soft tissues can be found nearly ...

[9] Result: noun | a usually malignant tumor arising from connective tissue (bone or muscle etc.); one of the four major types of cancer

Sarcoma is a rare type of cancer that can occur in various parts of the body, including bones, muscles, tendons, and soft tissues. The signs and symptoms of sarcoma can vary depending on the location and type of tumor.

Common Signs and Symptoms:

• A lump or mass that can be felt through the skin, which may or may not be painful [1]
• Bone pain, especially in the arms or legs [1]
• Abdominal pain, which can worsen over time [4]
• Unexplained fatigue, reduced appetite, unintended weight loss, and other symptoms associated with advanced sarcoma [2]

Other Possible Signs and Symptoms:

• Joint swelling and stiffness
• A limp
• Fever
• Weight loss
• Nausea and vomiting
• Diarrhea or constipation
• Blood in the stool or vomit
• Black, tarry stools (indicating internal bleeding)
• Feeling full sooner while eating
• Belly or back pain that doesn't go away
• Bloated or expanded belly

Warning Signs:

• A new lump or a growing lump anywhere on the body [4]
• Abdominal pain getting worse over time [4]
• Blood in stool or vomit [8]

It's essential to note that these symptoms can also be caused by other conditions, and only a medical professional can accurately diagnose sarcoma. If you're experiencing any of these symptoms, it's crucial to consult with a doctor for proper evaluation and treatment.

References: [1] Dec 28, 2022 [2] Symptoms of advanced sarcoma [3] Jul 26, 2024 [4] Apr 6, 2018 [5] What are the symptoms of sarcoma? [6] Sarcoma Symptoms and Warning Signs [7] A new lump or a lump that is growing anywhere on your body

Diagnostic Tests for Sarcoma

Sarcoma, a type of cancer that affects soft tissues such as muscles, tendons, and fat cells, requires accurate diagnosis to determine the best course of treatment. Various diagnostic tests can help identify sarcoma.

• Imaging Tests: Imaging tests are essential in diagnosing sarcoma. These include:
  • X-rays: Better for seeing bone problems [1].
  • CT (Computed Tomography) scans: Can show soft tissue tumors and their relationship with surrounding structures [2][5].
  • MRI (Magnetic Resonance Imaging): Excellent for visualizing soft tissues, including tumors [1][3].
  • Ultrasound: Can help identify tumors in the abdomen or pelvis [6][8].
• Biopsy: A biopsy is a crucial diagnostic test that involves taking a sample of cells from the tumor. This can be done through:
  • Needle biopsy: Guided by CT scans or ultrasound imaging to precisely target the tumor [9].
  • Surgical biopsy: May be necessary if imaging tests are inconclusive [3][7].

Additional Tests

Other tests may also be performed to support diagnosis and treatment planning:

• Blood Tests: Complete blood count (CBC) and blood clotting tests can help identify any abnormalities in blood cells or coagulation factors [4].
• PET Scans: Positron emission tomography scans can provide information on the metabolic activity of tumors, which may aid in diagnosis and staging [5].

Early Detection

Prompt diagnosis is essential for effective treatment. If imaging or screening tests suggest sarcoma, a biopsy should be performed to confirm the diagnosis.

References: [1] Dec 28, 2022 [2] Apr 6, 2018 [3] Unless imaging tests definitely rule out sarcoma... [4] Diagnosis of soft tissue sarcoma [5] Apr 27, 2023 [6] Tests for soft tissue sarcoma [7] Jun 6, 2022 [8] To diagnose soft tissue sarcoma [9] We typically perform needle biopsies...

Chemotherapy for Soft Tissue Sarcoma

Soft tissue sarcoma, a type of cancer that forms in soft tissues like fat, muscles, and blood vessels, can be treated with various drug treatments. Chemotherapy is one such treatment option.

• How Chemotherapy Works: Chemotherapy uses drugs to kill rapidly dividing cells, which are characteristic of cancer cells. This treatment generally targets cancer cells throughout the body [5].
• Types of Chemotherapy Drugs: Various chemotherapy drugs have been used to treat soft tissue sarcoma, including doxorubicin, ifosfamide, gemcitabine, and docetaxel [9]. Doxorubicin and ifosfamide are often the first choice for treatment, either alone or in combination with other drugs [9].
• Combination Therapy: Combining chemotherapy with other treatments like surgery and radiation therapy can be effective in treating soft tissue sarcoma. For example, combining doxorubicin with ifosfamide can lower the risk of sarcoma recurrence after surgery [8].

Targeted Medications

In addition to chemotherapy, targeted medications have also been used to treat soft tissue sarcoma.

• Regorafenib (Stivarga): This medication has been approved for treating soft tissue sarcoma and works by targeting specific proteins involved in cancer cell growth [2].
• Sorafenib (Nexavar): Another targeted medication, sorafenib, has also been used to treat soft tissue sarcoma by inhibiting certain enzymes that promote cancer cell growth [2].

Other Treatment Options

While chemotherapy and targeted medications are effective treatments for soft tissue sarcoma, other options like surgery and radiation therapy may also be considered.

• Surgery: Surgery is often the primary treatment for soft tissue sarcoma, especially if the tumor is localized. However, chemotherapy or radiation therapy may be used in conjunction with surgery to improve outcomes [3].
• Radiation Therapy: External and internal radiation therapies can be used to treat soft tissue sarcoma by targeting cancer cells directly [6].

References

[1] - Not relevant [2] Regorafenib (Stivarga) and Sorafenib (Nexavar) are targeted medications for treating soft tissue sarcoma. [3] Surgery is often the primary treatment for soft tissue sarcoma, especially if the tumor is localized. [4] Not relevant [5] Chemotherapy uses drugs to kill rapidly dividing cells, which are characteristic of cancer cells. [6] External and internal radiation therapies can be used to treat soft tissue sarcoma by targeting cancer cells directly. [7] Not relevant [8] Combining doxorubicin with ifosfamide can lower the risk of sarcoma recurrence after surgery. [9] Doxorubicin and ifosfamide are often the first choice for treatment, either alone or in combination with other drugs.

Differential Diagnosis of Sarcoma

Sarcomas are rare and malignant tumors that can be challenging to diagnose, especially in their early stages. The differential diagnosis for sarcoma includes a wide range of conditions, which can be broadly categorized into benign and malignant processes.

Benign Processes:

• Infections: Abscesses, cellulitis, and other soft tissue infections can mimic the presentation of sarcomas.
• Benign lesions: Ganglions, lipomas, schwannomas, and other types of benign tumors can be mistaken for sarcomas.
• Trauma: Myositis ossificans, a condition where muscle trauma leads to calcification, can present as a soft tissue mass.

Malignant Processes:

• Lymphoma: Certain types of lymphoma, such as non-Hodgkin lymphoma, can present with soft tissue masses.
• Metastatic carcinoma: Cancer that has spread from other parts of the body to the soft tissues can be mistaken for sarcoma.
• Inflammatory processes: Conditions like inflammatory myofibroblastic tumor (IMT) and xanthoma can mimic the presentation of sarcomas.

Rare Differential Diagnoses:

• Bacillary angiomatosis: A rare bacterial infection that can cause soft tissue masses, often difficult to distinguish from Kaposi sarcoma.
• Synovial sarcoma: Although it's a type of sarcoma itself, synovial sarcoma is often considered in the differential diagnosis due to its unique presentation.

Importance of Accurate Diagnosis

Accurate diagnosis of sarcoma is crucial for effective treatment and management. A thorough understanding of the differential diagnoses and their clinical presentations can help clinicians make informed decisions and improve patient outcomes.

References:

• [1] Results: A total of 490 patients ... to STS, the differential diagnoses for STT included 2% lymphomas, 18% isolated carcinoma metastases, 18% benign mesenchymal tumors, 5% inflammatory processes, and 2% old hematomas....
• [3] Although the majority of soft tissue masses are benign, it is important to consider malignancy in the differential diagnosis.
• [4] January 28, 2020 - Soft tissue sarcomas, the fifth most common solid tumors in children, are relatively rare and account for about 6-7% of all childhood malignancies.
• [9] February 1, 2022 - This led to a campaign to raise ... of a soft tissue mass can include infections such as abscess, benign lesions such as ganglion, lipoma, and schwannoma, trauma (myositis ossificans), other cancers, and secondary cancers.
• [10] Feb 15, 2022 — Diagnostic Considerations​​ Bacillary angiomatosis is often difficult to distinguish clinically from Kaposi sarcoma.