Oncology is a real scourge of modern society. Every year it takes millions of lives, sparing neither children nor adults. Cancer is a huge number of malignant diseases of various organs and systems of a person.
So, for example, there is such a dangerous disease as soft tissue sarcoma. Relative to other types of cancer, this disease is rare. The number of patients with it is no more than 1% of the total number of cancer patients.
Sarcoma is characterized by rapid progression, a high rate of spread of metastases and an unfavorable prognosis in most cases. As with any other cancer, survival is higher the earlier the tumor is diagnosed. Therefore, everyone needs to know about sarcoma in order to be able to notice signs of the disease in time and seek help.
Concept of the disease
So what is soft tissue sarcoma? This is an oncological disease in which the growth of malignant cells in different types of connective tissue is observed. In this case, it is replaced by fibrous. The vast majority of patients are between 30 and 50 years old. The disease affects men more often than women. However, in both cases it proceeds with the same aggressiveness and equal severity of symptoms of soft tissue sarcoma. Survival in representatives of both sexes is the same.
Types of Sarkom
In fact, sarcoma is the common name for a number of cancers. All of them differ from each other by the type of cells from which they originated.
- Angiosarcoma. It develops from vascular cells of the circulatory and lymphatic system. Extremely aggressive and quickly metastatic.
This species includes Kaposi's sarcoma, named after the scientist who first described it. It manifests itself in the form of multiple lesions of the skin or mucous membranes. The patient becomes covered with spots of red, brown or purple colors. They have an uneven outline, may rise slightly above the surface of the skin, and may be flat.
- Another type of sarcoma is the mesenchymoma. It is very rare, located deep in the muscles of the arms and legs.
- Fibrosarcoma. It comes from connective tissue cells and develops for a long time without causing any symptoms.
- Extra skeletal osteosarcoma. It arises from bone tissue, while being quite aggressive.
- Rhabdomyosarcoma. Formed from striated muscles. Often affects young children. A photo of the symptom of soft tissue sarcoma of this species is presented below.
- Schwannoma (neurinoma). It arises from a certain type of nerve sheath cells.
- Synovial sarcoma is a fairly rare type of sarcoma that occurs from the synovial membrane of the joint. This disease is characterized by extremely rapid metastasis.
In addition, sarcomas can be divided according to their degree of malignancy.
- Low level. When studying the structure of the tumor, a small number of foci of necrosis are noted.
- Middle level. The primary neoplasm is approximately half malignant.
- High level. The tumor is represented mainly by a large number of foci of necrosis.
Of course, the lower the degree of malignancy, the more favorable the prognosis.
There is sarcoma of the soft tissues of the head and face, as well as the hands, torso, and so on. Therefore, we can say that sarcoma can be divided into several types depending on the area of the human body on which it was formed.
I would also like to single out such a type of oncology as sarcoma of the soft tissues of the thigh (ICD-10 code - C49).
The fact is that the lower limbs are affected most often. In approximately 50-60% of patients with sarcoma, the lesion occurs precisely on the legs and mainly on the thigh area.
First of all, with this pathology, a glandular formation appears, which can rapidly grow. In addition, the affected limb becomes pale and cold to the touch. A patient with soft tissue sarcoma of the thigh may complain of general weakness, a constant increase in body temperature to subfebrile values. Laboratory blood tests may indicate a significant increase in ESR, platelet count, and a decrease in hemoglobin. Diagnosis and treatment do not differ from the sarcomas of other parts of the body.
Causes of Sarcoma
There are several factors that trigger the development of sarcoma. For instance:
- Any damage to the integrity of the skin and soft tissues - burn, scar, scar, fracture, and so on. Most often, a tumor occurs during the first three years after damage.
- The impact on the body of a number of chemicals with a carcinogenic effect. For example, toluene, benzene, arsenic, lead and others. These substances can cause DNA mutation in healthy cells and trigger a malignant process.
- Radiation exposure. Exposure to gamma rays causes the DNA of healthy cells to mutate and grow. In oncological practice, there are cases when the patient was irradiated with the aim of destroying one tumor, and after that he revealed the occurrence of soft tissue sarcoma. At risk are also people working with X-ray units or liquidating accidents in radiation zones.
- Among other things, some viruses also have mutagenic properties. For example, human immunodeficiency virus (HIV) and type 8 herpes are prone to cause Kaposi’s sarcoma.
- One of the leading factors is a hereditary predisposition. The fact is that in cancer patients the gene responsible for the prevention of malignant processes is damaged. And this is inherited.
- Among patients with certain types of sarcoma, adolescents can be found, more often than males. The fact is that the rapid hormonal growth that occurs during puberty can serve as an impetus for the development of oncology. Due to the rapid development of the body, immature cells can occur. This is especially true for hip sarcoma in adolescent boys.
Sarcoma metastasis
Everyone knows that any malignant tumor seeks to spread its cells in the patient’s body.
So, most sarcomas are prone to a rapid process of metastasis. Metastases are secondary malignant foci formed from the cells of the main tumor and spread throughout the body. There are two ways to move them - through the blood vessels and through the lymphatic vessels. For this disease, spread through the bloodstream is characteristic.
In fact, a tumor spreads its malignant cells from the very beginning. However, while the body’s immune system is strong, it is able to prevent the spread of cancer. But, as you know, cancer also affects the immune system, so it gradually fades away and can no longer be able to withstand the tumor. And then the green light for metastases turns on, they are carried with the bloodstream to all organs and systems.
So, metastases of sarcoma of soft tissues of the thigh affect mainly the nearest bone tissue. In addition, with sarcoma, the lungs, liver and bones are most often affected.
Soft tissue sarcoma. Symptoms
Sarcoma survival is low. For a long time, a person looks and feels absolutely healthy. The fact is that at first, soft tissue sarcoma occurs without any symptoms. A person does not even suspect that a malignant process is taking place inside his body.
At the initial stages of development of soft tissue sarcoma, as with any other type of cancer, specific symptoms are absent, but some manifestations of general malaise may occur:
- lack of appetite;
- weight loss;
- a feeling of constant weakness and fatigue;
- fever without any signs of a cold;
- decreased immunity, which is manifested in the too frequent occurrence of various viral and bacterial infections.
However, in practice there are patients who felt good, had an appetite and good blood test results, and so on.
Often the first and main symptom is the appearance of a tightening or swelling under the skin in any part of the body. Education can occur in any limb or on any part of the body where there is soft tissue (muscles, tendons, synovial tissue). The "favorite" place of the sarcoma is the hips. However, there are cases of damage to the head and neck.
Below is a photo of what sarcoma of soft tissues looks like at the initial stage.
The sizes of education can be very different - from 2 to 30 centimeters. However, the appearance of this symptom depends on the location of the tumor. If it is deep in the body, then it may not be visible. This is the insidiousness of the disease - for a long time it does not make itself felt.
The specific symptoms depend on the location of the lesion. For example, if the joints are affected, it will be very noticeable for the patient. He will not be able to move quietly, as during movement he will feel pain. Also, due to this location of the tumor, a person may lose the ability to freely move his hand or foot.
Signs of the disease in the last stages
As the tumor grows, the symptoms become more pronounced. In the last stages, a dark reddish color appears on the skin in the place where there is a neoplasm. There is a bleeding wound that is prone to frequent infection.
It should be noted that symptoms can be caused not only by the primary tumor, but also by secondary malignant foci. In this case, as the secondary foci grow, pain occurs, which gradually increase. The pain can be so intense that to stop it, specialists are forced to resort to narcotic drugs.
If the lungs are affected, the patient may experience shortness of breath, persistent cough, and a feeling of constriction in the chest area.
If the liver is affected, there may be pressure in the right hypochondrium, pain. The results of laboratory tests will indicate an increase in the level of liver enzymes (such as ALT, AST).
If symptoms of soft tissue sarcoma were detected at the earliest stages, survival in this case is maximum.
Medical diagnostics
Diagnosis of sarcoma is represented by a number of medical examinations and does not differ from the diagnosis of other cancers.
- X-ray In the picture you can find the shadow of the tumor, as well as possible deformation in the bone structures.
- Ultrasound examination in the field of a tumor. Using ultrasound, you can determine the exact size of the neoplasm, its borders, as well as the degree of damage to nearby tissues.
- CT (computed tomography) of the primary tumor. Gives a clearer picture of the structure of education, the degree of its malignancy.
- MRI (magnetic resonance imaging). Gives the most complete answer to all questions about the primary tumor.
- Puncture biopsy. It is the most important diagnostic method, without which it is impossible to make a final diagnosis. Only a biopsy can determine the nature of the cells, their malignancy.
Forecast
As mentioned above, doctors often give a disappointing prognosis to patients with sarcoma. The main factor determining survival in soft tissue sarcoma is the stage at which the cancer was detected. When a tumor is detected at the 1-2 stage, the prognosis is quite positive - about 80% of patients survive and live for the next five years. At the 3-4th stage, mortality is much higher. About 90% of patients die within five years. There is also a sarcoma, which is characterized by a very aggressive course. Almost all patients with this type of disease die in the next two or three years.
Thus, almost zero survival in inoperable people. Symptoms of soft tissue sarcoma in these patients most likely appeared only at the height of the disease, and they sought medical help too late. After all, the main tumor remains in the body, and it will continue to spread metastases with blood flow.
Treatment
Treating a patient suffering from sarcoma should include several methods. Only in this way will the patient have a chance of success. The primary treatment for soft tissue sarcoma is surgery to remove the tumor. However, sarcoma is characterized by a rapid onset of relapse. Most of the operated people already after several months showed repeated tumor growth. In addition, it is preferable to irradiate before surgery. This increases the chances of success.
Chemotherapy for sarcoma is used only as adjunctive therapy and most often in the latter stages of cancer when the tumor is inoperable. The most commonly used drugs are Decarbazine, Doxorubicin, Epirubicin. The dosage regimen, frequency of administration, duration of the course and their number are determined by the treating oncologist and are set individually for each patient.
Usually, doctors first administer radiation therapy for five weeks. By the decision of the oncologist, chemical therapy with anticancer activity can be added to it. After which the tumor is resected. This is the standard treatment for soft tissue sarcoma. Doctors' reviews suggest that this combination of methods is the most effective and gives the best possible favorable outcome.
Before the operation, the size of the tumor is necessarily studied and a biopsy is performed to evaluate malignancy. In the case of a small tumor (up to 5 cm), there is no need for radiation. If the tumor is more than 5 cm, then it should be affected by gamma rays in order to reduce and prevent further growth.
Conclusion
For a long time, a person may not have symptoms of soft tissue sarcoma. Survival is low and is associated with the late appeal of a person for help. In addition, this disease is quite aggressive, prone to frequent relapses and rapid metastasis. Therefore, everyone should know what sarcoma of soft tissues is, be able to notice alarming symptoms in themselves or loved ones on time. All this will help if you suspect a cancer, immediately seek help from a doctor. It can literally save a life.