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Soft Tissue Sarcomas (con't)

Overview of Soft Tissue Sarcomas

Definition of Soft Tissue Sarcomas:

Soft tissue refers to tissues that connect, support, or surround other structures and organs of the body. Soft tissue includes muscles, tendons, fibrous tissue, fat, blood vessels, nerves, and tissues around joints (synovial tissue).

Malignant (cancerous) tumors that develop in soft tissue are called sarcomas, a term that comes from a Greek word meaning "fleshy growth."

Major Types of Soft Tissue Sarcomas in Adults:

Tissue of Origin

Type of Cancer

Usual Location in the Body

Fibrous tissue

Fibrosarcoma

Arms, legs, trunk

 

Malignant fibrous
histiocytoma

Legs

 

Dermatofibrosarcoma

Trunk

Fat

Liposarcoma

Arms, legs, trunk

Muscle

 

 

 Striated muscle

Rhabdomyosarcoma

Arms, legs

 Smooth muscle

Leiomyosarcoma

Uterus, digestive tract

Blood vessels

Hemangiosarcoma

Arms, legs, trunk

 

Kaposi's sarcoma

Legs, trunk

Lymph vessels

Lymphangiosarcoma

Arms

Synovial tissue
(linings of joint cavities, tendon sheaths)

Synovial sarcoma

Legs

Peripheral nerves

Neurofibrosarcoma

Arms, legs, trunk

Cartilage and bone-forming tissue

Extraskeletal chondrosarcoma

Legs

 

Extraskeletal osteosarcoma

Legs, trunk (not
involving the bone)

Other types

Hemangiopericytoma
Myofibrosarcoma

 

Major Types of Soft Tissue Sarcomas in Children:

Tissue of Origin

Type of Cancer

Usual Location in the Body

Most common ages

Muscle

 

 

 

 Striated muscle

Rhabdomyosarcoma   Embryonal

Head and neck, genito-urinary tract

Infant-4

 

 Alveolar

Arms, legs, head and neck

Infant-19

 Smooth muscle

Leiomyosarcoma

Trunk

15-19

Fibrous tissue

Fibrosarcoma

Arms and legs

15-19

 

Malignant fibrous histiocytoma

Legs

15-19

 

Dermatofibrosarcoma

Trunk

15-19

Fat

Liposarcoma

Arms and legs

15-19

Blood vessels

Infantile hemangio-pericytoma

Arms, legs, trunk, head and neck

Infant-4

Synovial tissue
 (linings of joint cavities, tendon sheaths)

Synovial sarcoma

Legs, arms, and trunk

15-19

Peripheral nerves

Malignant peripheral nervesheath tumors (also called neurofibrosarcomas, malignant schwannomas, neurogenic sarcomas)

Arms, legs and trunk

15-19

Muscular nerves

Alveolar soft part sarcoma

Arms and legs

Infant-19

Cartilage and bone-forming tissue

Extraskeletal myxoid chondrosarcoma

Legs

10-14

Stages of Soft Tissue Sarcomas:

Stage I

  • Stage IA - The tumor is low grade, either near the surface or deep, and is less than 5 cm in size (about 2 inches) but has not spread to lymph nodes or other parts of the body.
  • Stage IB - The tumor is low-grade, near the surface, and more than 5 cm in size. It has not spread to lymph nodes or other parts of the body.

Stage II

  • Stage IIA - The cancer is low grade , deep, and more than 5 cm in size, but it has not spread to lymph nodes or other parts of the body.
  • Stage IIB - The cancer is high grade, either near the surface or deep, and less than 5 cm in size, but it has not spread to lymph nodes or other parts of the body.
  • Stage IIC - The cancer is high grade, near the surface, and is more than 5 cm in size, but it has not spread to lymph nodes or other parts of the body.

Stage III

The cancer is high grade, deep, more than 5 cm in size, but it has not spread to lymph nodes or other parts of the body.

Stage IV

The cancer may have spread to lymph nodes in the area or may have spread to other parts of the body, such as the lungs, head, or neck.

Recurrent

The cancer has come back (recurred) after it has been treated. It may come back in the tissues where it first started (locally recurrent), or it may come back in another part of the body metastatic).

Other Factors:

If the tumor is considered to be inoperable (unresectable), high-dose preoperative radiation therapy may be used to shrink the tumor so that surgery may be an option.

Location of the tumor is important. About 50% of soft tissue sarcomas occur in the extremities (the arms, legs, hands, or feet), 40% occur in the trunk (chest, back, hip, shoulders, and abdomen), and 10% occur in the head and neck.

Grades of Soft Tissue Sarcomas:

Grade indicates how the cancer cells look under a microscope and how quickly they are likely to grow and spread. Unlike most other cancers, the grade of a soft tissue sarcoma is more important than the size of the tumor.

Grades 1 and 2 are considered low-grade.

Grade I - well differentiated. The cells look very much like normal cells. These tumors grow and spread slowly.

Grade II - moderately differentiated. The cells look somewhat different from normal cells.

These tumors grow and spread less slowly than grade 1 tumors.

Grades 3 and 4 are considered high grade.

Grade III - poorly differentiated. The cells look very different from normal cells and grow and spread quickly.

Grade IV - undifferentiated. The cells appear very abnormal. The cancer grows and spreads very quickly. The cancer is considered to be "aggressive.


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