Soft tissue sarcomas. Osteogenic sarcoma Sarcoma of the abdominal wall ICD code 10

Sarcoma is a name that combines a large group of cancer tumors. Under certain conditions, different types of connective tissue begin to undergo histological and morphological changes. Then the primary connective cells begin to grow rapidly, especially in children. From such a cell a tumor develops: benign or malignant with elements of muscles, tendons, and blood vessels.

Connective tissue cells divide uncontrollably, the tumor grows and, without clear boundaries, moves into the territory of healthy tissue. 15% of neoplasms whose cells are carried by blood throughout the body become malignant. As a result of metastasis, secondary growing oncological processes are formed, therefore it is believed that sarcoma is a disease characterized by frequent relapses. In terms of lethal outcomes, it ranks second among all cancers.

Is sarcoma cancer or not?

Some signs of sarcoma are the same as those of cancer. For example, it also grows infiltratively, destroys neighboring tissues, recurs after surgery, metastasizes early and spreads in organ tissues.

How does cancer differ from sarcoma?

• The cancer tumor has the appearance of a lumpy conglomerate that grows rapidly without symptoms in the first stages. Sarcoma is pinkish in color, reminiscent of fish flesh;
• a cancer tumor affects epithelial tissue, sarcoma affects muscle connective tissue;
• Cancer development occurs gradually in any specific organ in people after 40 years of age. Sarcoma is a disease of young people and children; it instantly affects their bodies, but is not tied to any one organ;
• Cancer is easier to diagnose, which increases cure rates. Sarcoma is more often detected at stages 3-4, so its mortality rate is 50% higher.

Is sarcoma contagious?

No, she is not contagious. An infectious disease develops from a real substrate that carries infection by airborne droplets or through the blood. Then a disease, such as influenza, can develop in the body of a new host. You can get sarcoma as a result of changes in the genetic code or chromosomal changes. Therefore, patients with sarcoma often have close relatives who have already been treated for any of its 100 types.

Sarcoma in HIV is a multiple hemorrhagic sarcomatosis called "angiosarcoma" or "". It is recognized by ulcerations of the skin and mucous membranes. A person becomes ill as a result of herpes infection type 8 through the lymph, blood, secretions of the patient’s skin and saliva, as well as through sexual contact. Even with antiviral therapy, Kaposi's tumor often recurs.

The development of sarcoma against the background of HIV is possible with a sharp decrease in immunity. In this case, patients may be diagnosed with AIDS or a disease such as lymphosarcoma, leukemia, lymphogranulomatosis or myeloma.

Causes of sarcomas

Despite the variety of types, sarcoma is rare, accounting for only 1% of all cancers. The causes of sarcoma are varied. Among the established causes are: exposure to ultraviolet (ionizing) radiation, radiation. Viruses and chemicals, precursors of the disease, and benign neoplasms that turn into oncological ones also become risk factors.

The causes of Ewing's sarcoma may be the rate of bone growth and hormonal levels. Risk factors such as smoking, working in chemical plants, and contact with chemicals are also important.

Most often, this type of oncology is diagnosed due to the following risk factors:

• hereditary predisposition and genetic syndromes: Werner, Gardner, multiple pigmented skin cancer of basal cells, neurofibromatosis or retinoblastoma;
• herpes virus;
• lymphostasis of the legs in a chronic form, the recurrence of which occurred after radial mastectomy;
• injuries, wounds with suppuration, exposure to cutting and piercing objects (shards of glass, metal, wood chips, etc.);
• immunosuppressive and polychemotherapy (10%);
• organ transplant operations (in 75% of cases).

Informative video

General symptoms and signs of the disease

Signs of sarcoma appear depending on its location in vital organs. The nature of the symptoms is influenced by the biological characteristics of the root cause of the cell and the tumor itself. Early signs of sarcoma are the noticeable size of the formation, as it grows rapidly. Pain in joints and bones appears early (especially at night), which is not relieved by analgesics.

For example, due to the growth of rhabdominosarcoma, the oncological process spreads to the tissues of healthy organs and is manifested by various pain symptoms and hematogenous metastasis. If sarcoma develops slowly, signs of the disease may not appear for several years.

Symptoms of lymphoid sarcoma are reduced to the formation of oval or round nodes and small swellings in the lymph node. But even with sizes of 2-30 cm, a person may not feel pain at all.

With other types of tumors with rapid growth and progression, the following may appear: fever, veins under the skin, and cyanotic ulcerations on them. Palpation of the formation reveals that it has limited mobility. The first signs of sarcoma are sometimes characterized by deformation of the joints of the limbs.

Liposarcoma, along with other types, can be of a primary multiple nature with sequential or simultaneous manifestation in different areas of the body. This significantly complicates the search for the primary tumor that produces metastases.

Symptoms of sarcoma located in soft tissues are expressed in painful sensations on palpation. Such a tumor has no outline, and it quickly penetrates into nearby tissues.

With a pulmonary oncological process, the patient suffers from shortness of breath, which causes oxygen starvation of the brain, pneumonia, pleurisy, dysphagia may begin, and the right side of the heart may enlarge.

Cells of the nerve sheaths degenerate into neurofibrosarcoma, cells and connective tissue fibers into. Spindle cell sarcoma, consisting of large cells, affects the mucous membranes. Mesothelioma grows from the mesothelium of the pleura, peritoneum and pericardium.

Types of sarcomas by location

Types of sarcoma are distinguished depending on their location.

AND Of the 100 types, sarcomas most often develop in the area:

• peritoneum and retroperitoneal space;
• neck, head and bones;
• mammary glands and uterus;
• stomach and intestines (stromal tumors);
• fatty and soft tissues of the limbs and trunk, including desmoid fibromatosis.

New ones are especially often diagnosed in fatty and soft tissues:

• , developing from adipose tissue;
• , which refers to fibroblastic/myofibroblastic formations;
• fibrohistiocytic tumors of soft tissues: plexiform and giant cell;
• – from smooth muscle tissue;
• glomus tumor (pericytic or perivascular);
• from the muscles of the skeleton;
• and epithelioid hemangioepithelioma, which refers to vascular formations of soft tissue;
• mesenchymal chondrosarcoma, extraskeletal osteosarcoma – osteochondral tumors;
• malignant gastrointestinal tract tumor (stromal tumor of the gastrointestinal tract);
• tumors of the nerve trunk: peripheral nerve trunk, triton tumor, granulocelloma, ectomesenchymoma;
• sarcomas of unclear differentiation: synovial, epithelioid, alveolar, clear cell, Ewing, desmoplastic round cell, intimal, PEComu;
• undifferentiated/unclassified sarcoma: spindle cell, pleomorphic, round cell, epithelioid.

According to the WHO classification (ICD-10), the following tumors are often found among bone tumors:

• cartilage tissue - chondrosarcoma: central, primary or secondary, peripheral (periosteal), clear cell, dedifferentiated and mesenchymal;
• bone tissue - osteosarcoma, a common tumor: chondroblastic, fibroblastic, osteoblastic, as well as telangiectatic, small cell, central low-grade, secondary and paraosteal, periosteal and superficial high-grade;
• fibrous tumors – fibrosarcoma;
• fibrohistiocytic formations - malignant fibrous histiocytoma;
• / PNET;
• hematopoietic tissue - plasmacytoma (myeloma), malignant lymphoma;
• giant cell: malignant giant cell;
• tumor formation of the notochord - “Dedifferentiated” (sarcomatoid);
• vascular tumors – angiosarcoma;
• smooth muscle tumors – leiomyosarcoma;
• tumors from adipose tissue - liposarcoma.

The maturity of all types of sarcomas can be low-, medium- and highly differentiated. The lower the differentiation, the more aggressive the sarcoma. Treatment and survival prognosis depend on the maturity and stage of formation.

Stages and degrees of malignant process

There are three degrees of malignancy of sarcoma:

1. Poorly differentiated degree, in which the tumor consists of more mature cells and the process of their division occurs slowly. It is dominated by stroma - normal connective tissue with a small percentage of oncoelements. The tumor rarely metastasizes and recurs little, but can grow to large sizes.
2. A highly differentiated degree in which tumor cells divide rapidly and uncontrollably. With rapid growth, a sarcoma forms a dense vascular network with a large number of high-grade cancer cells, and metastases spread early. Surgical treatment of high-grade lesions may be ineffective.
3. Moderately differentiated degree, in which the tumor has intermediate development, and with adequate treatment a positive prognosis is possible.

The stages of sarcoma do not depend on its histological type, but on its location. It determines the stage based on the condition of the organ where the tumor began to develop.

The initial stage of sarcoma is characterized by small size. It does not spread beyond the organs or segments where it originally appeared. There are no disturbances in the working functions of organs, compression, or metastasis. There is virtually no pain. If a well-differentiated stage 1 sarcoma is detected, positive results are achieved with complex treatment.

Signs of the initial stage of sarcoma, depending on the location in a particular organ, for example, are the following:

• in the oral cavity and on the tongue - a small node up to 1 cm in size appears in the submucosal layer or mucous membrane and has clear boundaries;
• on the lips - the node is felt in the submucosal layer or inside the lip tissue;
• in the cellular spaces and soft tissues of the neck - the size of the node reaches 2 cm, it is located in the fascia that limits its location and does not extend beyond its limits;
• in the area of ​​the larynx - the mucous membrane or other layers of the larynx limit the node, up to 1 cm in size. It is located in the fascial sheath, does not extend beyond it and does not interfere with phonation and breathing;
• in the thyroid gland - a node, up to 1 cm in size, located inside its tissues, capsule germination does not occur;
• in the mammary gland - a node up to 2-3 cm grows in the lobule and does not extend beyond its limits;
• in the area of ​​the esophagus - an oncological node up to 1-2 cm is located in its wall, without disturbing the passage of food;
• in the lung - manifested by damage to one of the segments of the bronchi, without going beyond its limits and without disrupting the working function of the lung;
• in the testicle - a small node develops without involving the tunica albuginea;
• in the soft tissues of the extremities - the tumor reaches 5 cm, but is located within the fascial sheaths.

Stage 2 sarcoma is located inside the organ, grows into all layers, disrupts the functional functioning of the organ as it increases in size, but there is no metastasis.

The oncological process manifests itself like this:

• in the oral cavity and on the tongue - noticeable growth in the thickness of the tissues, germination of all membranes, mucosa and fascia;
• on the lips - by germination of the skin and mucous membranes;
• in the cellular spaces and soft tissues of the neck - up to 3-5 cm in height, extending beyond the fascia;
• in the area of ​​the larynx – the growth of the node is more than 1 cm, the germination of all layers, which disrupts phonation and breathing;
• in the thyroid gland – the growth of the node is more than 2 cm and the involvement of the capsule in the oncological process;
• in the mammary gland – node growth up to 5 cm and germination of several segments;
• in the esophagus - by germination of the entire thickness of the wall, including the mucous and serous layers, involvement of the fascia, severe dysphagia (difficulty swallowing);
• in the lungs - compression of the bronchi or spread to the nearest pulmonary segments;
• in the testicle - by germination of the tunica albuginea;
• in the soft tissues of the extremities - by the germination of fascia limiting the anatomical segment: muscle, cellular space.

At the second stage, when the tumor is removed, the excision area is expanded, so relapses are not frequent.

Stage 3 sarcoma is characterized by invasion of the fascia and nearby organs. Metastasis of the sarcoma to regional lymph nodes occurs.

The third stage appears:

• large sizes, severe pain, disruption of normal anatomical relationships and chewing in the oral cavity and tongue, metastases in the lymph nodes under the jaw and on the neck;
• large in size, deforming the lip, spreading through the mucous membranes and metastases to the lymph nodes under the jaw and on the neck;
• dysfunction of organs located along the neck: innervation and blood supply, swallowing and respiratory functions are disrupted in soft tissue sarcoma of the neck and cellular spaces. As the tumor grows, it reaches blood vessels, nerves and nearby organs; metastases reach the lymph nodes of the neck and sternum;
• sudden respiratory failure and distortion of the voice, germination into organs, nerves, fascia and vessels in the neighborhood, metastasis from laryngeal cancer to the superficial and deep lymphatic cervical collectors;
• in the mammary gland - large in size, which deforms the mammary gland and metastasizes to the lymph nodes under the armpits or above the collarbone;
• in the esophagus - huge in size, reaching the mediastinal tissue and disrupting the food passage, metastases in the mediastinal lymph nodes;
• in the lungs – compression of the bronchi with large sizes, metastases in the mediastinal and peribronchial lymph nodes;
• in the testicle – deformation of the scrotum and germination of its layers, metastasis to the groin lymph nodes;
• in the soft tissues of the arms and legs - tumor foci measuring 10 centimeters. As well as dysfunction of the limbs and tissue deformation, metastases to regional lymph nodes.

At the third stage, extended surgical interventions are performed, despite this, the frequency of sarcoma relapses increases, and treatment results are ineffective.

Stage 4 sarcoma is very difficult, the prognosis after its treatment is the most unfavorable due to its gigantic size, sharp compression of surrounding tissues and germination into them, the formation of a continuous tumor conglomerate, which is prone to bleeding. Often there is a relapse of sarcoma of soft tissues and other organs after surgery or even complex treatment.

Metastasis reaches regional lymph nodes, liver, lungs, and bone marrow. It stimulates a secondary oncological process - the growth of a new sarcoma.

Metastases in sarcoma

The routes of metastasis of sarcoma can be lymphogenous, hematogenous and mixed. From the pelvic organs, intestines, stomach and esophagus, larynx, sarcoma metastases reach the lungs, liver, skeletal bones and other organs through the lymphatic pathway.

Through the hematogenous route (through venous and arterial vessels), tumor cells or metastases also spread to healthy tissues. But sarcomas, for example, of the mammary and thyroid glands, pulmonary, bronchial, and from the ovaries, spread by lymphogenous and hematogenous routes.

It is impossible to predict the organ where elements of the microvasculature will accumulate and the growth of a new tumor will begin. Dust metastases of sarcoma of the stomach and pelvic organs spread throughout the peritoneum and thoracic region with hemorrhagic effusion - ascites.

The oncological process on the lower lip, tip of the tongue and in the oral cavity metastasizes more to the lymph nodes of the chin and under the jaw. Formations in the root of the tongue, at the bottom of the oral cavity, in the pharynx, larynx, and thyroid gland metastasize to the lymph nodes of the vessels and nerves of the neck.

From the mammary gland, cancer cells spread to the clavicle area, to the lymph nodes on the outside of the sternocleidomastoid muscle. From the peritoneum they reach the inner side of the sternocleidomastoid muscle and can be located behind or between its legs.

Most metastasis occurs in adults, lymphosarcoma, liposarcoma, fibrous histiocytoma, even with a size of up to 1 cm due to the accumulation of calcium in the tumor focus, intense blood flow and active growth of cancer cells. These formations lack a capsule that could limit their growth and reproduction.

The course of the oncological process does not become more complicated, and its treatment in connection with metastases to regional lymph nodes will not be so global. With distant metastases in the internal organs, on the contrary, the tumor grows to a large size, there may be several of them. Treatment becomes more complicated; complex therapy is used: surgery, chemotherapy and radiation. As a rule, single metastases are removed. Excision of multiple metastases is not performed; it will not be effective. Primary foci differ from metastases in a large number of vessels and cell mitoses. Metastases have more necrotic areas. Sometimes they are found earlier than the primary focus.

The consequences of sarcoma are as follows:

• surrounding organs are compressed;
• obstruction or perforation may occur in the intestine, peritonitis - inflammation of the abdominal layers;
• elephantiasis occurs due to impaired lymph outflow due to compression of the lymph nodes;
• limbs are deformed and movement is limited in the presence of large tumors in the area of ​​bones and muscles;
• Internal hemorrhages occur during the disintegration of tumor formation.

Diagnosis of sarcomas

Diagnosis of sarcoma begins in the doctor's office, where it is determined by external diagnostic signs: exhaustion, jaundice, pale skin color and change in its color over the tumor, cyanotic tint of the lips, swelling of the face, congestion of the veins on the surface of the head, plaques and nodules in cutaneous sarcoma.

Diagnosis of high-grade sarcoma is carried out by pronounced symptoms of intoxication of the body: decreased appetite, weakness, elevated body temperature and sweating at night. Cases of cancer in the family are taken into account.

When carrying out laboratory tests, the following is examined:

• biopsy by histological method under a microscope. In the presence of tortuous thin-walled capillaries, multidirectional bundles of atypical cancer cells, altered large-nucleated cells with a thin membrane, a large amount of substance between the cells containing cartilaginous or hyaline connective tissue substances, histology diagnoses sarcoma. At the same time, the nodes lack normal cells characteristic of organ tissue.
• abnormalities in the chromosomes of oncological cells using the cytogenetic method.
• There are no specific blood tests for tumor markers, so there is no way to unambiguously determine its type.
• General blood test: for sarcoma will show the following abnormalities:

1. hemoglobin and red blood cell levels will decrease significantly (less than 100 g/l), which indicates anemia;
2. the level of leukocytes will increase slightly (above 9.0x109/l);
3. the platelet count will decrease (less than 150․109/l);
4. ESR will increase (above 15 mm/hour).

• biochemical blood test, it determines an increased level of lactate dehydrogenase. If the enzyme concentration is above 250 U/l, then we can talk about the aggressiveness of the disease.

Diagnosis of sarcoma is complemented by a chest x-ray. The method can detect a tumor and its metastases in the sternum and bones.

Radiological signs of sarcoma are as follows:

• the tumor is round or irregular in shape;
• the size of the formation in the mediastinum ranges from 2-3 mm to 10 cm or more;
• the structure of the sarcoma will be heterogeneous.

X-ray is necessary to detect pathology in lymph nodes: one or more. In this case, the lymph nodes on the x-ray will be darkened.

If sarcoma is diagnosed by ultrasound, it will be characteristic, for example:

• heterogeneous structure, uneven scalloped edges and lymph node damage - with lymphosarcoma in the peritoneum;
• absence of a capsule, compression and expansion of surrounding tissues, foci of necrosis inside the tumor - with sarcoma in the organs and soft tissues of the abdominal cavity. Nodes will be noticeable in the uterus and kidneys (inside) or in the muscles;
• formations of different sizes without borders and with foci of decay inside them - with skin sarcoma;
• multiple formations, heterogeneous structure and metastases of the primary tumor - with fatty sarcoma;
• heterogeneous structure and cysts inside, filled with mucus or blood, unclear edges, effusion in the cavity of the joint capsule - with sarcoma of the joints.

Tumor markers for sarcoma are determined in each specific organ, as in cancer. For example, for ovarian cancer - for sarcoma of the breast - for gastrointestinal tract - CA 19-9 or lung - ProGRP (precursor of gastrin releasing peptide), etc.

Computed tomography is performed with the introduction of an x-ray contrast agent to determine the location, boundaries of the tumor and its shape, damage to surrounding tissues, vessels, lymph nodes and their fusion into conglomerates.

Magnetic resonance imaging is performed to identify the exact size, metastases, destruction of the skin, bones, tissues, fibering of the periosteum, thickening of the joints, etc.

The diagnosis is confirmed by a biopsy and malignancy is determined by histological examination:

• bundles of tangled spindle-shaped cells;
• hemorrhagic exudate - fluid coming out of the walls of blood vessels;
• hemosiderin - a pigment formed during the breakdown of hemoglobin;
• giant atypical cells;
• mucus and blood in the sample, etc.

A lumbar puncture (spinal puncture) test will indicate sarcoma, where there may be traces of blood and many atypical cells of different sizes and shapes.

Do not remove:

• after 75 years;
• for severe diseases of the heart, kidneys and liver;
• with a large tumor in vital organs that cannot be removed.

The following treatment tactics are also used:

1. For low- and moderately differentiated sarcomas at stages 1-2, operations and regional lymph node dissection are performed. After – polychemotherapy (1-2 courses) or external beam radiation therapy for sarcoma.
2. For highly differentiated sarcomas at stages 1-2, surgical treatment and extended lymph node dissection are performed. is performed before and after surgery, and in case of complex treatment it is added.
3. At the third stage of the oncological process, combined treatment is carried out: before surgery - radiation and chemotherapy to reduce the size of the tumor. During the operation, all growing tissues and regional lymphatic drainage collectors are removed. Restore important damaged structures: nerves and blood vessels.
4. Amputation is often required for sarcoma, especially osteosarcoma. Resection of the bone area is performed for poorly differentiated superficial osteosarcomas in older people. Next, prosthetics are performed.
5. At stage 4, symptomatic treatment is used: correction of anemia, detoxification and analgesic therapy. For comprehensive, complete treatment at the last stage, access to the tumor formation is required for the purpose of its removal, small size, location in the superficial layers of tissue, and single metastases.

Modern methods include external beam radiation therapy with linear accelerators using special programs that plan irradiation fields and calculate the power and dose of exposure to the oncological process area. Radiotherapy is carried out under full computerized control and automatic verification of the correctness of the settings specified on the accelerator control panel to eliminate human error. used for sarcomas of different locations. It precisely irradiates the tumor with a high dose of radiation without damaging healthy tissue. The source is inserted into it by remote control. Brachytherapy can replace surgery and external radiation in some cases.

Traditional medicine for sarcoma

Treatment of sarcoma with folk remedies is part of complex therapy. For each type of sarcoma there is its own medicinal herb, mushrooms, resins, and food products. Diet during cancer is of great importance, since fortified foods and the presence of micro- and macroelements increase immunity, give strength to fight cancer cells, and prevent metastasis.

For malignant sarcomas, treatment is carried out:

• infusions;
• alcohol tinctures;
• decoctions;
• poultices.

Herbs used:

• black henbane;
• spotted hemlock;
• oxwort;
• cocklebur;
• white water lily;
• clematis;
• poppy samosa;
• sun milk,
• red fly agaric;
• knotty burrow;
• white mistletoe;
• incense pikulnik;
• evasive peony;
• European wormwood;
• common hop;
• common blackhead;
• greater celandine;
• saffron sativa;
• tall ash.

For old sarcoma ulcers on the skin and mucous membranes, treat with auranium officinalis, cutaneous sarcoma with wolfberry, sweet clover, cocklebur, kirkazon and clematis, milkweed and bittersweet nightshade, common tansy and European dodder, common hop and garlic om medicinal.

During an oncological process in organs, the following drugs will be needed:

• in the stomach - from wolfberry, black crow, datura and cocklebur, peony, greater celandine and wormwood;
• in the duodenum - from aconites, swamp whiteweed;
• in the esophagus - from spotted hemlock;
• in the spleen - from wormwood;
• in the prostate gland - from spotted hemlock;
• in the mammary gland - from spotted hemlock, leftwort and common hop;
• in the uterus - from evasive peony, wormwood, Lobel's hellebore and saffron;
• in the lungs - from the magnificent crocus and cocklebur.

Osteogenic sarcoma is treated with a tincture: crushed St. John's wort (50 g) is poured with grape vodka (0.5 l) and infused for two weeks with daily shaking of the container. Before meals, take 30 drops 3-4 times.

For sarcoma, folk remedies are used according to the method of M.A. Ilves (from the book “The Red Book of the White Land”):

1. To increase immunity: mix in equal weight fractions: tartar (flowers or leaves), calendula flowers, tricolor and field violet, cocklebur, chamomile flowers and speedwell, celandine and immortelle flowers, mistletoe and young burdock root. Brew 2 tbsp. l. collect 0.5-1 liters of boiling water and leave for 1 hour. Drink during the day.
2. Divide the herbs from the list into 2 groups (5 and 6 names each) and drink each collection for 8 days.

Important! When collected, plants such as celandine, violet, cocklebur and mistletoe are poisonous. Therefore, the dose cannot be exceeded.

To eliminate cancer cells, treatment of sarcoma with folk remedies includes the following Ilves recipes:

• Grind the celandine in a meat grinder and squeeze out the juice, mix with vodka in equal parts (preserve) and store at room temperature. Drink 3 times a day, 1 tsp. with water (1 glass);
• Grind 100 g of marina root (peony evasive) and add vodka (1 l) or alcohol (75%), leave for 3 weeks. Take 0.5-1 tsp. 3 times with water;
• Grind the mistletoe, place it in a jar (1 liter) 1/3 full, fill it to the top with vodka and let it brew for 30 days. Separate the grounds and squeeze, drink 1 tsp. 3 times with water;
• chop meadowsweet root – 100 g and add vodka – 1 liter. Leave for 3 weeks. Drink 2-4 tsp. 3 times a day with water.

The first three tinctures should be alternated every 1-2 weeks. Meadowsweet tincture is used as a reserve. All tinctures are taken for the last time before the evening dinner. Course - 3 months, in the break between the monthly course (2 weeks) - drink meadowsweet. At the end of the 3-month course, drink meadowsweet or one of the tinctures once a day for another 30 days.

Nutrition for sarcoma

The diet for sarcoma should consist of the following products: vegetables, greens, fruits, fermented milk rich in bifido- and lactobacteria, boiled (steamed, stewed) meat, cereals as a source of complex carbohydrates, nuts, seeds, dried fruits, bran and sprouted cereals , wholemeal bread, cold-pressed vegetable oils.

To block metastases, the diet includes:

• fatty sea fish: saury, mackerel, herring, sardine, salmon, trout, cod;
• green and yellow vegetables: zucchini, cabbage, asparagus, green peas, carrots and pumpkin;
• garlic.

You should not eat confectionery products, since they are stimulators of cancer cell division, as well as sources of glucose. Also products with tannin: persimmon, coffee, tea, bird cherry. Tannin, as a hemostatic agent, promotes thrombus formation. Smoked meats are excluded as sources of carcinogens. You should not drink alcohol or beer, the yeast of which feeds cancer cells with simple carbohydrates. Avoid acidic berries: lemons, lingonberries and cranberries, since cancer cells actively develop in an acidic environment.

Prognosis for life with sarcoma

The five-year survival rate for sarcoma of soft tissues and extremities can reach 75%, and up to 60% for cancer on the body.
In fact, even the most experienced doctor does not know how long people live with sarcoma. According to research, life expectancy for sarcoma is influenced by the forms and types, stages of the oncological process, and the general condition of the patient. With adequate treatment, a positive prognosis is possible for the most hopeless cases.

Disease Prevention

Primary prevention of sarcoma involves active identification of patients at increased risk of developing the disease, including those infected with herpes virus VIII (HHV-8). It is especially necessary to carefully monitor patients receiving. Prevention involves eliminating and treating the conditions and diseases that cause sarcoma.

Secondary prevention is carried out for patients in remission to prevent relapse of sarcoma and complications after a course of treatment. As a preventive measure, instead of tea, you should drink brewed herbs according to the Ilves method (step 1) for 3 months, take a break of 5-10 days and repeat the intake. You can add sugar or honey to tea.

Soft tissue sarcomas occur in any part of the body. In about half, the tumor is localized on the lower extremities. The hip is most commonly affected. In 25% of patients, sarcoma is located on the upper extremities. The rest are on the torso and occasionally on the head.
A malignant soft tissue tumor has the appearance of a rounded nodule of whitish or yellowish-gray color with a bumpy or smooth surface. The consistency of the neoplasm depends on the histological structure. It can be dense (fibrosarcomas), soft (liposarcomas and angiosarcomas) and even jelly-like (myxomas). Soft tissue sarcomas do not have a true capsule, however, during the process of growth, the neoplasm compresses the surrounding tissues, the latter become denser, forming a so-called false capsule, which quite clearly outlines the tumor.
A malignant neoplasm usually occurs in the thickness of the deep layers of muscle. As the tumor increases in size, it gradually spreads to the surface of the body. Growth is accelerated under the influence of injury and physical therapy.
The tumor is usually single, but some types of sarcomas are characterized by multiple lesions. Sometimes they occur at a great distance from each other (multiple liposarcoma, malignant neuromas in Recklinhausen disease).
Metastasis of malignant neoplasms of soft tissue occurs predominantly through the hematogenous route (through blood vessels). The favorite location of metastases is the lungs. Less commonly, the liver and bones are affected. Metastases to lymph nodes occur in 8–10% of cases.
A feature of soft tissue neoplasms is the existence of a group of tumors intermediate between benign and malignant. These tumors have locally recurrent infiltrating growth, often recur, but do not metastasize or metastasize extremely rarely (desmoid tumors of the abdominal wall, intermuscular or embryonal lipomas and fibromas, differentiated fibrosarcomas, etc.).
The leading sign is the appearance of a painless node or swelling of a round or oval shape. The size of the node varies from 2–3 to 25–30. The nature of the surface depends on the type of tumor. The boundaries of the tumor in the presence of a pronounced false capsule are clear, but with a deep tumor, the contours of the swelling are unclear and difficult to define. The skin is usually not changed, but compared to the healthy side above the tumor there is a local increase in temperature, and with massive, rapidly growing formations that reach the surface, a network of dilated saphenous veins, cyanotic coloration and infiltration or ulceration of the skin appears. The mobility of the palpable formation is limited. This serves as one of the most characteristic and important symptoms for diagnosis.
Occasionally, soft tissue sarcomas lead to deformation of the limbs, causing a feeling of heaviness and awkwardness when moving, but the function of the limb is rarely impaired.
“Alarm signals”, in the presence of which a suspicion of soft tissue sarcoma should be raised, are:
- the presence of a gradually increasing tumor formation;
- limitation of the mobility of the existing tumor;
- the appearance of a tumor emanating from the deep layers of soft tissues;
- the appearance of swelling after a period of several weeks to 2–3 years or more after the injury.

Sarcoma is a neoplasm that often has a malignant course. There are many different sarcomas, which are classified into a single disease in ICD 10. The danger of the pathology lies in the absence of symptoms in the initial stages of development of the tumor, which complicates diagnosis.

General concept of sarcoma

Sarcoma can be localized in various tissue areas. It can affect muscles, epithelium, nerve fibers, and connective tissue. In medicine, there are three main types of sarcomas: conditionally benign, malignant and intermediate, accompanied by metastatic lesions.

The disease is diagnosed in both men and women. But in male patients, sarcoma is diagnosed more often.

The main feature of the formations, which distinguishes them from other types of tumors, is that they form in soft tissues. Metastases appear in the liver, brain, and lungs. As a result, cancerous damage to the injured organs develops.

In medicine, many different sarcomas are distinguished depending on their composition:

• epithelioid;
• angiosarcoma;
• fibrous histiocytoma;
• fibrosarcoma;
• leiomyosarcoma;
• rhabdomyosarcoma;
• liposarcoma;
• schwannoma;
• spindle cell sarcoma;
• hemangiopericytoma;
• mesenchymoma;
• synovial sarcoma;
• alveolar.

The type of sarcoma is determined based on the results of instrumental diagnostic methods by a specialist. This is necessary because many of the formations can transform into malignant tumors and become the cause of metastatic lesions.

Causes

Experts were unable to establish the true reasons for the formation of sarcoma. But they have identified a number of factors that can influence and increase the risk of developing the disease.

Genetic predisposition is of great importance in the formation of tumors of various types. It was found that in patients diagnosed with fibrosarcoma or another type of formation, close relatives suffered from a similar pathology.

One of the factors causing sarcomas is the herpes virus. Experts also say that carcinogenic, chemical, toxic and poisonous substances also have an effect on the body.

Unfavorable environmental conditions in the patient’s areas of residence can also significantly increase the risk of sarcoma formation.

Scientists believe that the causes of tumor formation are regular damage to the skin, long-term use of steroid drugs and the presence of precancerous diseases.

Clinical picture

Despite the fact that in medicine there are many types of sarcomas, they have similar symptoms, as a result of which they were combined into one group.

At the initial stages of tumor development, signs of the disease do not appear. As the tumor grows, the patient experiences a sharp weight loss, constant fatigue, depression and fatigue.

The advanced stage of cancer is characterized by pain in the affected area and impaired performance of the affected organ. The skin at the location of the tumor changes its color, and ulcers appear on its surface.

The tumor is most often defined as a small nodule. It is distinguished by a yellowish or white color. In the initial stages of its development, it is not accompanied by painful sensations.

The surface of the formation is smooth, but as it develops it becomes bumpy and ulcers appear. The size of the tumor can reach 30 centimeters.

The danger of sarcoma is that it does not appear for a long time and the patient is not aware of its presence. If sarcoma affects muscle tissue, it becomes noticeable in the later stages of development, when there is no chance of successful recovery.

Diagnostics

Establishing the disease in the presence of sarcoma is difficult in some cases, due to the absence of symptoms in the initial stages. A preliminary diagnosis is established based on the patient’s complaints and external examination. In order to confirm it and determine the characteristics of the course of the pathology, the specialist prescribes a number of instrumental and laboratory diagnostic methods:

Ultrasonography

The technique is quite informative and allows you to determine the presence of a tumor that is localized in the soft tissues of the thigh, limbs and other parts of the body.

Ultrasound helps determine the size, location, and structure of the tumor. Sarcoma has certain characteristics that distinguish it from other types of diseases. First of all, it does not have a capsule and a homogeneous structure. Also, foci of necrosis in sarcoma are located inside the formation.

CT scan

If sarcoma is suspected, CT is often performed using a contrast agent. This allows you to determine the area of ​​circulatory disturbance. When performing a computed tomography scan, sarcoma is determined by its irregular shape, unclear contours, and heterogeneous structure. Adjacent tissues are also damaged and compressed. The contrast agent accumulates in the tortuous vessels.

Magnetic resonance imaging

Prescribed when it is impossible to conduct a computed tomography scan. The technique is quite informative. The main advantage of MRI is the ability to visualize a tumor layer-by-layer, determine its structure, size, and location.

Radiography

X-ray examination is carried out to determine metastatic lesions not only in neighboring organs or tissues, but also in distant ones.

The disadvantage of the technique is that it is impossible to determine the type of tumor using an x-ray machine.

Biopsy

A fine-needle biopsy for sarcoma is prescribed to confirm the type of formation and the presence of cancer cells. The collection procedure is carried out using a special apparatus, in which a specialist extracts a sample of sarcoma tissue.

The obtained samples are sent to the laboratory for histological examination. The patient can learn the diagnostic results from his attending physician after 7-10 days. In some cases, the study is done on an emergency basis. The result is ready after 20-30 minutes.

Patients should also undergo a general and biochemical blood test. A specialist may order a plasma test for tumor markers. Angiography and positron emission tomography are indicated as additional research methods.

Based on the research results, a final diagnosis is established and a course of therapy is prescribed.

Treatment

When diagnosing sarcoma, treatment is carried out on an individual basis. Before prescribing a course of therapy, a consultation of doctors is held.

Despite the fact that there is no single treatment system for embryonal rhabdomyosarcoma, fibrosarcoma and other types of sarcomas, surgery is often prescribed. The goals of the operation are to remove the tumor, alleviate the patient's condition and increase his life expectancy.

Surgery in some cases may be supplemented with radiation or chemotherapy. The techniques can slow down tumor growth, but have a number of side effects. Undesirable effects include hair loss, brittle nails, weakness, nausea and weight loss. That is why they are not prescribed for the treatment of patients over 60 years of age.

In cases where the sarcoma is large enough and affects many nerve endings and great vessels, it is removed along with the affected organ.

Chemotherapy is carried out in two or three courses. The interval between them is at least 3 weeks. Radiation therapy in some cases is prescribed as the main method of therapy. It is performed if the patient has contraindications to surgery or the tumor is small in size.

After treatment, the patient is registered at the dispensary. The patient should visit his or her physician regularly at scheduled intervals for preventive purposes.

Complications

Sarcoma of soft tissues of peripheral nerves, connective or muscle tissue, if left untreated, can cause serious complications. Among them are:

1. Spreading metastatic lesions.
2. Squeezing surrounding tissues and organs, which causes significant pain.
3. Development obstruction intestines and organ perforation.
4. Defeat lymphatic system, resulting in disruption of its performance.
5. The emergence of internal bleeding.

With the development of various types of sarcoma, there is a decrease in hearing, vision, memory loss and concentration. The sensitivity of the skin is also impaired. That is why treatment should not be delayed when diagnosing sarcoma.

Forecast

The prognosis for the development of sarcoma is influenced by many different factors. First of all, this is the stage of the disease. Also of great importance are the localization of the tumor process, age, condition of the patient, the presence of metastatic lesions, and concomitant diseases.

The prognosis is more favorable when treatment was started at stages 1 or 2 of the pathology. The survival rate of patients is about 70-50%. But sarcoma is dangerous because after removal the tumor forms again.

Most often, the prognosis for sarcoma is unfavorable, which is due to the fact that in the initial stages of development it is quite difficult to determine the presence of pathology. The survival rate of patients at stages 3 or 4 is no more than 15%.

Prevention measures

Since the true causes of sarcoma development have not been established, there are no special preventive measures. Doctors recommend following the basic rules:

1. Attend on time doctor Regular examinations and X-ray examinations will help to timely determine the onset of the development of the tumor process.
2. News active Lifestyle. If work involves staying in one position for a long time, it is recommended to do exercises every hour and perform morning exercises daily.
3. More walk in the fresh air. A park is suitable for these purposes. You should dress according to the weather to avoid catching a cold.
4. Treat in a timely manner colds diseases.
5. Right eat. Eating fast food and fast food has a negative impact on the immune system. You need to introduce more vegetables and fruits into your diet. In autumn and spring you need to take vitamin complexes. This will help maintain immunity at the desired level.
6. Eliminate exposure chemical, toxic and toxic substances on the skin and the body as a whole. When working in hazardous industries, you must use personal protective equipment, and do housework only with gloves.
7. Avoid injury skin.

Compliance with preventive measures will help to significantly reduce the risk of developing various types of sarcoma. It is important for patients to know that only timely treatment increases the likelihood of recovery from the disease.

Soft tissue sarcoma is a common disease among other cancers. In medicine, there are many different types of formations, but all of them pose a great danger to the health and life of the patient. In the initial stages, sarcoma does not show symptoms, which complicates diagnosis.

That is why patients are recommended to undergo annual preventive examinations. When sarcoma is diagnosed, treatment should not be delayed, since its absence causes serious consequences, including death.

Morbidity. Soft tissue sarcomas account for 1% of all malignant neoplasms in adults. Tumors affect men and women equally, most often between the ages of 20 and 50 years. Possible occurrence in childhood (10-11% of sarcomas).

Code according to the international classification of diseases ICD-10:

Histogenesis. The source of growth is the most heterogeneous tissues in structure and origin. Basically, these are derivatives of mesenchyme: fibrous connective, adipose, synovial and vascular tissues, as well as tissues associated with mesoderm (striated muscles) and neuroectoderm (nerve sheaths). It should be taken into account that every third soft tissue tumor cannot be classified using conventional microscopy due to the difficulty of determining histogenesis. In such cases, immunohistochemical examination can provide significant assistance.

Histogenetic classification. Mesenchyme: .. Malignant mesenchymoma.. Myxoma. Fibrous tissue: .. Desmoid (invasive form) .. Fibrosarcoma. Adipose tissue - liposarcoma. Vascular tissue: .. Malignant hemangioendothelioma.. Malignant hemangiopericytoma.. Malignant lymphangiosarcoma. Muscle tissue: .. Transversely striated muscles - rhabdomyosarcoma.. Smooth muscles - leiomyosarcoma. Synovial tissue - synovial sarcoma. Nerve sheaths: .. Neuroectodermal - malignant neuroma (schwannoma).. Connective tissue - perineural fibrosarcoma. Unclassified blastomas.

Causes

Risk factors. Ionizing radiation. Effect of chemicals (for example, asbestos or wood preservatives). Genetic disorders. For example, 10% of patients with von Recklinghausen disease develop neurofibrosarcoma. Pre-existing bone diseases. Osteosarcoma develops in 0.2% of patients with Paget's disease (ostosis deformans).

Symptoms (signs)

Clinical picture. Sarcomas can develop anywhere on the trunk or extremities and usually appear as a painless tumor of varying consistency and density. Sarcomas that arise in the deep parts of the thigh and retroperitoneum usually reach large sizes by the time of diagnosis. Patients usually note a decrease in body weight and complain of pain of unknown localization. In the distal parts of the extremities, even a small tumor attracts attention early. Bleeding is the most common manifestation of sarcomas of the gastrointestinal tract and female genital organs.

Diagnostics

Diagnostics. Rapid growth, location of the tumor below or at the level of the deep fascia, signs of infiltrative growth, fixation to other anatomical structures, raise serious suspicions about the malignant nature of the process. Biopsy.. Fine-needle aspiration biopsy does not give an idea of ​​the histological structure and degree of differentiation, but only confirms the presence of a malignant tumor.. Trepan - biopsy or excisional biopsy makes it possible to establish a final diagnosis for choosing a treatment method.. When choosing a place for a biopsy, one should take into account the possible subsequently reconstructive (plastic) surgery. Radiological examination: radiography, bone scintigraphy, MRI, CT.. For some types of sarcomas and when planning organ-conserving surgery, MRI is preferable - diagnostics that provide a more accurate determination of the boundary between tumors and soft tissues.. CT and bone scintigraphy are preferable for detecting bone lesions.. If there are signs of liver dysfunction in sarcomas of internal organs or extremities, ultrasound and CT (to identify metastases) are performed. If vascular proliferation is suspected, contrast angiography is indicated.

Classification

TNM classification (Kaposi's sarcoma, dermatofibrosarcoma, grade I desmoid tumors, sarcomas of the dura mater, brain, parenchymal organs or visceral membranes are not classified).. Primary lesion. The depth of location in the classification is taken into account as follows: ... Superficial - “a” - the tumor does not involve the (most) superficial muscular fascia... Deep - “b” - the tumor reaches or grows into the (most) superficial muscular fascia. This includes all visceral tumors and/or tumors, invading large vessels, and intrathoracic lesions. Most head and neck tumors are also considered deep... T1 - tumor up to 5 cm in greatest dimension... T2 - tumor more than 5 cm in greatest dimension.. Regional lymph nodes (N)... N1 - there are metastases in the regional lymph nodes nodes.. Distant metastases... M1 - there are distant metastases.

Grouping by stages: .. Stage IA - G1 - 2T1a - 1bN0M0 - well-differentiated, small-sized tumors, regardless of location.. Stage IB - G1 - 2T2aN0M0 - well-differentiated, large-sized tumors, located superficially.. Stage IIA - G1 - 2T2bN0M0 - well-differentiated, large tumors, located deep.. Stage IIB - G3 - 4T1a - 1bN0M0 - poorly differentiated, small tumors, regardless of location.. Stage IIC - G3 - 4T2aN0M0 - poorly differentiated, large tumors, located superficially.. Stage III - G3 - 4T2bN0M0 - poorly differentiated, large tumors, located deep.. Stage IV - the presence of any metastases - G1 - 4T1a - 2bN1M0, G1 - 4T1a - 2bN0M1.

Treatment

Treatment, general principles

When choosing treatment regimens, it is recommended to adhere to the age of 16 years and older, as the criterion for an adult, but the choice of treatment method must be chosen by consultation. For example, rhabdomyosarcoma can be successfully treated using pediatric regimens up to the age of 25, but poorly differentiated fibrosarcoma at the age of 14 should be treated as in an adult - surgically.

Tumors of the extremities and superficially located tumors of the torso are subject to surgical removal using the principles of “sheathing”. Possible skin deficiency is not an obstacle to intervention. If the tumor is presenting to the bone, it is removed along with the periosteum, and if it grows, a planar or segmental resection of the bone is performed. When microscopic detection of malignant cells at the edges of the resected tissue, the muscle-fascial sheath is resected. Radiation therapy is indicated when the tumor edge is located less than 2-4 cm from the resection line or when the wound is contaminated with tumor cells.

Tumors of the posterior mediastinum, retroperitoneal in the pelvis and paravertebral, are often unremovable. Small tumors of the anterior mediastinum and retroperitoneal tumors in the left half of the body can be removed surgically. For doubtfully operable tumors, preoperative radiation or thermoradiotherapy, regional chemotherapy, and chemoembolization of the vessels feeding the tumor are performed. Since tumors of these locations are often detected in late stages and radical removal is often not possible, the operation is supplemented with radiation therapy. If relapses develop, repeated interventions are indicated.

Recurrence is a characteristic biological feature of sarcomas; therefore, combined and complex treatment methods are being developed.

Features of treatment measures depend on the histological structure of the tumor. Neurogenic sarcoma and fibrosarcomas are insensitive to radiation and chemotherapy; treatment (including relapses) is only surgical. Angiosarcoma and liposarcoma are relatively sensitive to radiation therapy (preoperative telegammatherapy is required). Myogenic and synovial sarcomas require neoadjuvant chemotherapy and radiation therapy.

Solitary metastases of sarcomas in the lungs are subject to surgical removal (wedge resection), followed by chemotherapy. Most often, such metastases occur within 2 to 5 years after the initial operation.

In case of complications of tumor growth, it is possible to perform palliative resections, which can reduce intoxication, blood loss from disintegrating tumors, and eliminate symptoms of compression of other organs (ureteral obstruction, intestinal compression with symptoms of intestinal obstruction, etc.).

TYPES OF SOFT TISSUE SARCOMAS

Fibrosarcoma accounts for 20% of malignant soft tissue lesions. It occurs more often in women 30-40 years old. The tumor consists of atypical fibroblasts with varying amounts of collagen and reticular fibers. Clinical picture.. Localization - soft tissues of the extremities (thigh, shoulder girdle), less often the trunk, head, neck.. The most important sign is the absence of skin lesions over the tumor.. Metastases in regional lymph nodes are noted in 5-8% of patients. Hematogenous metastases (most often in the lungs) - in 15-20%. Treatment is excision of the tumor, observing zonality and casing. Forecast. With adequate treatment, the 5-year survival rate is 77%.

Liposarcoma is registered in 15% of cases of soft tissue tumors. Occur more often at the age of 40-60 years. The tumor consists of anaplastic fat cells and areas of myxoid tissue. Clinical picture.. Most often the tumor is located on the lower extremities and in the retroperitoneal space.. It is extremely rare that liposarcomas develop from single and multiple lipomas.. Typically early hematogenous metastasis to the lungs (30-40%). Treatment is wide excision; for larger tumors, preoperative radiation therapy is warranted. Forecast. In patients with differentiated tumors, the 5-year survival rate is 70%, with poorly differentiated tumors - 20%.

Rhabdomyosarcoma- a malignant tumor originating from skeletal (striated) muscle. There are embryonic (develops up to 15 years) and adult types of rhabdomyosarcoma. Frequency. It ranks 3rd among malignant soft tissue neoplasms. It is registered at any age, but more often in adolescents and in the middle age group. Women get sick 2 times more often.

Pathomorphology. The tumor consists of spindle-shaped or round cells, in the cytoplasm of which longitudinal and transverse striations are determined. Genetic aspects. The development of rhabdomyosarcomas is expected to involve several genes located on the ridge. 1, 2, 11, 13 and 22; the possible role of genomic imprinting or duplication of individual genes (for example, the insulin-like growth factor 2 gene IGF2, the PAX3 and PAX7 genes) is being considered.

Clinical picture.. Most often, tumors are localized in three anatomical areas of the body: limbs, head and neck, pelvis.. The tumor grows quickly, without pain and dysfunction of organs.. They often invade the skin with the formation of exophytic bleeding formations.. Early recurrence is characteristic. Treatment— surgical; for large tumors, preoperative radiation therapy is advisable. When carrying out combined (surgical, chemotherapy) treatment of localized forms of embryonal rhabdomyosarcoma, an increase in 5-year survival rate of up to 70% is noted. In the presence of metastases, the 5-year survival rate is 40%. For pleomorphic rhabdomyosarcoma (tumor of adults), the 5-year survival rate is 30%.

Synonyms. Rhabdosarcoma. Rhabdomyoblastoma. Malignant rhabdomyoma

Angiosarcoma accounts for about 12% of all soft tissue neoplasms. The tumor is more often observed in young people (under 40 years of age). Morphology.. Hemangioendothelioma is formed from many atypical capillaries with proliferation of atypical endothelial cells filling the lumen of the vessels.. Hemangiopericytoma, developing from modified cells of the outer lining of the capillaries. Clinical picture.. The tumor has infiltrating rapid growth, is prone to early ulceration and fusion with surrounding tissues.. Early metastasis to the lungs and bones, dissemination to the soft tissues of the body is quite common. Treatment - surgery is combined with radiation therapy.

Lymphangiosarcoma(Stewart-Treves syndrome) is a specific tumor that develops in the area of ​​constant lymphatic edema (upper limb in women with postmastectomy syndrome, especially after a course of radiation therapy). The prognosis is unfavorable.

Leiomyosarcoma makes up 2% of all sarcomas. The tumor consists of atypical elongated cells with rod-shaped nuclei. Clinical picture.. On the extremities the tumor is located in the projection of the vascular bundle.. The tumor is always solitary. Treatment is surgical.

Synovial sarcoma It ranks 3rd-4th in frequency among soft tissue sarcomas (8%). It is registered mainly in people under 50 years of age. The tumor consists of juicy spindle-shaped and round cells. Clinical picture... Localization in the hand and foot area is typical. Treatment is surgical, with regional lymph node dissection.

Malignant neuromas- a rather rare pathology (about 7% of soft tissue lesions.. The tumor consists of elongated cells with elongated nuclei. Clinical picture.. They are most often located on the lower extremities.. Primary tumor multiplicity is characteristic.. Recurrence is possible. Treatment is surgical. Prognosis. The main prognostic factors are the degree of histological differentiation and tumor size; in patients with low-grade neuroma, the prognosis is less favorable. Tumor size is an independent prognostic factor. Small (less than 5 cm) completely removed well-differentiated tumors rarely recur and metastasize.

Kaposi's sarcoma(see Kaposi's Sarcoma).

ICD-10. C45 Mesothelioma. C46 Kaposi's sarcoma. C47 Malignant neoplasm of peripheral nerves and autonomic nervous system. C48 Malignant neoplasm of the retroperitoneum and peritoneum. C49 Malignant neoplasm of other types of connective and soft tissues.

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Sarcoma is a disease that involves malignant neoplasms of various locations. Let's look at the main types of sarcoma, symptoms of the disease, methods of treatment and prevention.

Sarcoma is a group of malignant neoplasms. The disease begins with damage to primary connective cells. Due to histological and morphological changes, a malignant formation begins to develop, which contains elements of cells, blood vessels, muscles, tendons and other things. Among all forms of sarcoma, particularly malignant ones account for about 15% of neoplasms.

The main symptomatology of the disease manifests itself in the form of swelling of any part of the body or node. Sarcoma affects: smooth and striated muscle tissue, bone, nervous, adipose and fibrous tissue. Diagnostic methods and treatment methods depend on the type of disease. The most common types of sarcoma:

• Sarcoma of the trunk, soft tissues of the extremities.
• Sarcoma of the bones, neck and head.
• Retroperitoneal sarcomas, muscle and tendon lesions.

Sarcoma affects connective and soft tissues. In 60% of the disease, the tumor develops on the upper and lower extremities, in 30% on the torso, and only in rare cases, sarcoma affects the tissues of the neck and head. The disease occurs in both adults and children. Moreover, about 15% of sarcoma cases are cancerous. Many oncologists consider sarcoma to be a rare type of cancer that requires special treatment. There are many names for this disease. The names depend on the tissue in which they appear. Bone sarcoma is osteosarcoma, cartilage sarcoma is chondrosarcoma, and smooth muscle tissue lesions are leiomyosarcoma.

ICD-10 code

Sarcoma ICD 10 is a classification of the disease according to the tenth revision of the International Cataloger of Diseases.

Code according to the international classification of diseases ICD-10:

• C45 Mesothelioma.
• C46 Kaposi's sarcoma.
• C47 Malignant neoplasm of peripheral nerves and autonomic nervous system.
• C48 Malignant neoplasm of the retroperitoneum and peritoneum.
• C49 Malignant neoplasm of other types of connective and soft tissues.

Each of the points has its own classification. Let's look at what each of the categories of the international classification of diseases of sarcoma ICD-10 implies:

• Mesothelioma is a malignant neoplasm originating from the mesothelium. Most often it affects the pleura, peritoneum and pericardium.
• Kaposi's sarcoma is a tumor that develops from blood vessels. The peculiarity of the neoplasm is the appearance on the skin of red-brown spots with pronounced edges. The disease is malignant and therefore poses a threat to human life.
• Malignant neoplasm of peripheral nerves and autonomic nervous system - in this category there are lesions and diseases of the peripheral nerves, lower extremities, head, neck, face, chest, hip area.
• Malignant neoplasm of the retroperitoneum and peritoneum - soft tissue sarcomas affecting the peritoneum and retroperitoneum, causing thickening of parts of the abdominal cavity.
• A malignant neoplasm of other types of connective and soft tissues - sarcoma affects soft tissues on any part of the body, causing the appearance of a cancerous tumor.

ICD-10 code

C45-C49 Malignant neoplasms of mesothelial and soft tissues

Causes of sarcoma

The causes of sarcoma are varied. The disease can occur due to environmental factors, injury, genetic factors and more. Specifying the cause of sarcoma development is simply impossible. But, there are several risk factors and causes that most often provoke the development of the disease.

• Hereditary predisposition and genetic syndromes (retinoblastoma, Gardner syndrome, Werner syndrome, neurofibromatosis, pigmented basal cell multiple skin cancer syndrome).
• The influence of ionizing radiation - tissues exposed to radiation are subject to infection. The risk of developing a malignant tumor increases by 50%.
• The herpes virus is one of the factors in the development of Kaposi's sarcoma.
• Lymphostasis of the upper extremities (chronic form), developing against the background of radial mastectomy.
• Injuries, wounds, suppuration, exposure to foreign bodies (shards, splinters, etc.).
• Polychemotherapy and immunosuppressive therapy. Sarcomas appear in 10% of patients who have undergone this type of therapy, as well as in 75% after organ transplant operations.

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Symptoms of sarcoma

Symptoms of sarcoma are varied and depend on the location of the tumor, its biological characteristics and the underlying cells. In most cases, the initial symptom of sarcoma is a tumor that gradually increases in size. So, if a patient has bone sarcoma, that is, osteosarcoma, then the first sign of the disease is terrible pain in the bone area that occurs at night and is not relieved by analgesics. As the tumor grows, neighboring organs and tissues are involved in the pathological process, which leads to a variety of painful symptoms.

• Some types of sarcomas (bone sarcoma, parosteal sarcoma) develop very slowly and asymptomatically over many years.
• But rhabdomyosarcoma is characterized by rapid growth, spread of the tumor to adjacent tissues and early metastasis, which occurs hematogenously.
• Liposarcoma and other types of sarcomas are primarily multiple in nature, appearing sequentially or simultaneously in different places, which complicates the issue of metastasis.
• Soft tissue sarcoma affects surrounding tissues and organs (bones, skin, blood vessels). The first sign of soft tissue sarcoma is a tumor without limited outlines, causing pain on palpation.
• With lymphoid sarcoma, a tumor appears in the form of a node and a small swelling in the area of ​​the lymph node. The neoplasm has an oval or round shape and does not cause pain. The size of the tumor can be from 2 to 30 centimeters.

Depending on the type of sarcoma, an elevated temperature may appear. If the tumor progresses rapidly, subcutaneous veins appear on the surface of the skin, the tumor becomes cyanotic in color, and ulcers may appear on the skin. When palpating the sarcoma, the mobility of the tumor is limited. If sarcoma appears on the extremities, it can lead to their deformation.

Sarcoma in children

Sarcoma in children is a series of malignant tumors that affect the organs and systems of the child’s body. Most often, children are diagnosed with acute leukemia, that is, a malignant lesion of the bone marrow and circulatory system. In second place in terms of frequency of diseases are lymphosarcoma and lymphogranulomatosis, tumors in the central nervous system, osteosarcoma, soft tissue sarcoma, tumors of the liver, stomach, esophagus and other organs.

Sarcomas in pediatric patients occur for several reasons. First of all, it is genetic predisposition and heredity. In second place are mutations in the child’s body, injuries and damage received, past illnesses and a weakened immune system. Sarcomas are diagnosed in children, as well as in adults. To do this, they resort to the methods of computer and magnetic resonance imaging, ultrasound, biopsy, cytological and histological examination.

Treatment of sarcoma in children depends on the location of the tumor, the stage of the tumor, its size, the presence of metastases, the age of the child and the general condition of the body. For treatment, surgical methods of tumor removal, chemotherapy and radiation are used.

• Malignant diseases of the lymph nodes

Malignant diseases of the lymph nodes are the third most common disease that occurs in both children and adults. Most often, oncologists diagnose lymphogranulomatosis, lymphomas, and lymphosarcoma. All these diseases are similar in their malignancy and the substrate of the lesion. But there are a number of differences between them, in the clinical course of the disease, treatment methods and prognosis.

• Lymphogranulomatosis

Tumors affect the cervical lymph nodes in 90% of cases. Most often, this disease affects children under 10 years of age. This is explained by the fact that at this age, serious changes occur in the lymphatic system at the physiological level. Lymph nodes become very vulnerable to irritants and viruses that cause certain diseases. With a tumor disease, the lymph nodes increase in size, but are absolutely painless on palpation, the skin over the tumor does not change color.

To diagnose lymphogranulomatosis, a puncture is used and the tissue is sent for cytological examination. Malignant disease of the lymph nodes is treated with radiation and chemotherapy.

• Lymphosarcoma

A malignant disease that occurs in the lymphatic tissues. In its course, symptoms and tumor growth rate, lymphosarcoma is similar to acute leukemia. Most often, the neoplasm appears in the abdominal cavity, mediastinum, that is, the chest cavity, in the nasopharynx and peripheral lymph nodes (cervical, inguinal, axillary). Less commonly, the disease affects bones, soft tissues, skin and internal organs.

The symptoms of lymphosarcoma resemble those of a viral or inflammatory disease. The patient develops a cough, fever and general ailments. As the sarcoma progresses, the patient complains of swelling of the face and shortness of breath. The disease is diagnosed using radiography or ultrasound. Treatment can be surgical, chemotherapy and radiation.

• Kidney tumors

Kidney tumors are malignant neoplasms that, as a rule, are congenital in nature and appear in patients at an early age. The true causes of kidney tumors are unknown. Sarcomas, leiomyosarcomas, and myxosarcomas occur on the kidneys. The tumors may be round cell carcinomas, lymphomas, or myosarcomas. Most often, the kidneys are affected by spindle-shaped, round cell and mixed types of sarcomas. At the same time, the mixed type is considered the most malignant. In adult patients, kidney tumors metastasize extremely rarely, but can reach large sizes. And in pediatric patients, tumors metastasize, affecting surrounding tissues.

To treat kidney tumors, surgical methods are usually used. Let's look at some of them.

• Radical nephrectomy - the doctor makes an incision in the abdominal cavity and removes the affected kidney and surrounding fatty tissue, the adrenal glands that are adjacent to the affected kidney, and regional lymph nodes. The operation is performed under general anesthesia. The main indications for nephrectomy: large size of the malignant tumor, metastasis to regional lymph nodes.
• Laparoscopic surgery - the advantages of this treatment method are obvious: minimally invasive, short recovery period after surgery, less pronounced postoperative pain and better aesthetic results. During the operation, several small punctures are made in the skin of the abdomen, through which a video camera is inserted, thin surgical instruments are introduced, and air is pumped into the abdominal cavity to remove blood and excess tissue from the surgical area.
• Ablation and thermal ablation are the most gentle method of removing kidney tumors. The tumor is exposed to low or high temperatures, which leads to the destruction of the kidney tumor. The main types of this treatment: thermal (laser, microwave, ultrasound), chemical (ethanol injections, electrochemical lysis).

Types of sarcoma

The types of sarcoma depend on the location of the disease. Depending on the type of tumor, certain diagnostic and therapeutic techniques are used. Let's look at the main types of sarcoma:

1. Sarcoma of the head, neck, bones.
2. Retroperitoneal neoplasms.
3. Sarcoma of the uterus and mammary glands.
4. Gastrointestinal stromal tumors.
5. Damage to soft tissues of the limbs and trunk.
6. Desmoid fibromatosis.

Sarcomas arising from hard bone tissue:

• Ewing's sarcoma.
• Parosteal sarcoma.
• Osteosarcoma.
• Chondrosarcoma.
• Reticulosarcoma.

Sarcomas arising from muscle, fat and soft tissue:

• Kaposi's sarcoma.
• Fibrosarcoma and skin sarcoma.
• Liposarcoma.
• Soft tissue and fibrous histiocytoma.
• Synovial sarcoma and dermatofibrosarcoma.
• Neurogenic sarcoma, neurofibrosarcoma, rhabdomyosarcoma.
• Lymphangiosarcoma.
• Sarcomas of internal organs.

The group of sarcomas consists of more than 70 different variants of the disease. Sarcoma is also distinguished by malignancy:

• G1 - low degree.
• G2 - medium level.
• G3 - high and extremely high degree.

Let's take a closer look at certain types of sarcoma that require special attention:

• Alveolar sarcoma - most often occurs in children and adolescents. It rarely metastasizes and is a rare type of tumor.
• Angiosarcoma - affects the vessels of the skin and develops from blood vessels. Occurs in internal organs, often after irradiation.
• Dermatofibrosarcoma is a type of histiocytoma. It is a malignant tumor arising from connective tissue. Most often it affects the torso and grows very slowly.
• Extracellular chondrosarcoma is a rare tumor that arises from cartilaginous tissue, is localized in cartilage and grows into bones.
• Hemangiopericytoma is a malignant tumor of blood vessels. It looks like nodes and most often affects patients under 20 years of age.
• Mesenchymoma is a malignant tumor growing from vascular and adipose tissue. Affects the abdominal cavity.
• Fibrous histiocytoma is a malignant tumor localized on the extremities and closer to the torso.
• Schwannoma is a malignant tumor that affects the nerve sheaths. It develops independently, rarely metastasizes, and affects deep tissues.
• Neurofibrosarcoma develops from Schwann tumors around neuronal processes.
• Leiomyosarcoma - appears from the rudiments of smooth muscle tissue. It spreads quickly throughout the body and is an aggressive tumor.
• Liposarcoma - arises from adipose tissue and is localized on the trunk and lower extremities.
• Lymphangiosarcoma - affects the lymphatic vessels, most often occurs in women who have had a mastectomy.
• Rhabdomyosarcoma - arises from striated muscles and develops in both adults and children.

• Kaposi's sarcoma is usually caused by the herpes virus. Often found in patients taking immunosuppressants and those infected with HIV. The tumor develops from the dura mater, hollow and parenchymal internal organs.
• Fibrosarcoma - occurs on ligaments and muscle tendons. Very often it affects the feet, less often the head. The tumor is accompanied by ulcers and actively metastasizes.
• Epithelioid sarcoma - affects the peripheral areas of the extremities, in young patients. The disease is actively metastasizing.
• Synovial sarcoma – occurs in the articular cartilage and around the joints. It can develop from the synovial membranes of the vaginal muscles and spread to the bone tissue. Due to this type of sarcoma, the patient has reduced motor activity. Most often occurs in patients aged 15-50 years.

Stromal sarcoma

Stromal sarcoma is a malignant tumor that affects internal organs. Typically, stromal sarcoma affects the uterus, but this disease is rare, occurring in 3-5% of women. The only difference between sarcoma and uterine cancer is the course of the disease, the process of metastasis and treatment. A predictive sign of the appearance of sarcoma is undergoing a course of radiation therapy to treat pathologies in the pelvic area.

Stromal sarcoma is predominantly diagnosed in patients aged 40-50 years, while during menopause, sarcoma occurs in 30% of women. The main symptoms of the disease appear in the form of bloody discharge from the genital tract. Sarcoma causes pain due to enlargement of the uterus and compression of its neighboring organs. In rare cases, stromal sarcoma is asymptomatic and can only be recognized after visiting a gynecologist.

Spindle cell sarcoma

Spindle cell sarcoma consists of spindle-shaped cells. In some cases, during histological examination, this type of sarcoma is confused with fibroma. The tumor nodes have a dense consistency; when cut, a white-gray fibrous structure is visible. Spindle cell sarcoma appears on the mucous membranes, skin, serous tissue and fascia.

Tumor cells grow randomly, singly or in bunches. They are located in various directions relative to each other, intertwining and forming a ball. The size and location of sarcoma are varied. With timely diagnosis and prompt treatment, it has a positive prognosis.

Malignant sarcoma

Malignant sarcoma is a soft tissue tumor, that is, a pathological formation. There are several clinical signs that unite malignant sarcomas:

• Localization deep in muscles and subcutaneous tissues.
• Frequent relapses of the disease and metastasis to the lymph nodes.
• Asymptomatic tumor growth for several months.
• The location of the sarcoma in the pseudocapsule and frequent germination beyond it.

Malignant sarcoma recurs in 40% of cases. Metastases occur in 30% of patients and most often affect the liver, lungs and brain. Let's look at the main types of malignant sarcoma:

• Malignant fibrous histiocytoma is a soft tissue tumor localized in the trunk and extremities. When performing an ultrasound examination, the tumor does not have clear contours and may be adjacent to the bone or involve blood vessels and muscle tendons.
• Fibrosarcoma is a malignant formation of connective fibrous tissue. As a rule, it is localized in the shoulder and hip area, in the thickness of the soft tissues. Sarcoma develops from intermuscular fascial formations. Metastasizes to the lungs and occurs most often in women.
• Liposarcoma is a malignant sarcoma of adipose tissue with many varieties. It occurs in patients of all ages, but most often in men. It affects the limbs, tissues of the thigh, buttocks, retroperitoneum, uterus, stomach, spermatic cord, and mammary glands. Liposarcoma can be single or multiple, simultaneously developing on several parts of the body. The tumor grows slowly, but can reach very large sizes. The peculiarity of this malignant sarcoma is that it does not grow into bones and skin, but can recur. The tumor metastasizes to the spleen, liver, brain, lungs and heart.
• Angiosarcoma is a malignant sarcoma of vascular origin. It occurs in both men and women, aged 40-50 years. Localized on the lower extremities. The tumor contains blood cysts, which become a source of necrosis and hemorrhage. Sarcoma grows very quickly and is prone to ulceration, and can metastasize to regional lymph nodes.
• Rhabdomyosarcoma is a malignant sarcoma that develops from striated muscles and ranks 3rd among malignant soft tissue lesions. As a rule, it affects the limbs and develops in the thickness of the muscles in the form of a node. On palpation it is soft with a dense consistency. In some cases, it causes hemorrhage and necrosis. Sarcoma is quite painful and metastasizes to the lymph nodes and lungs.
• Synovial sarcoma is a malignant tumor of soft tissues that occurs in patients of all ages. As a rule, it is localized on the lower and upper extremities, in the area of ​​the knee joints, feet, thighs, and legs. The tumor has the shape of a round node, limited from surrounding tissues. Inside the formation there are cysts of different sizes. Sarcoma recurs and can metastasize even after a course of treatment.
• Malignant neuroma is a malignant tumor that occurs in men and in patients suffering from Recklinghausen's disease. The tumor is localized on the lower and upper extremities, head and neck. Metastasizes rarely; it can metastasize to the lungs and lymph nodes.

Pleomorphic sarcoma

Pleomorphic sarcoma is a malignant tumor that affects the lower extremities, trunk and other places. In the early stages of development, the tumor is difficult to diagnose, so it is detected when it reaches 10 or more centimeters in diameter. The formation is a lobed, dense node, reddish-gray in color. The node contains an area of ​​hemorrhage and necrosis.

Pleomorphic fibrosarcoma recurs in 25% of patients and metastases to the lungs in 30% of patients. Due to the progression of the disease, the tumor often causes death within a year from the date of discovery of the formation. The survival rate of patients after detection of this formation is 10%.

Polymorphic cell sarcoma

Polymorphic cell sarcoma is a rather rare autonomous type of primary skin sarcoma. The tumor develops, as a rule, along the periphery of the soft tissues, and not in depth, and is surrounded by an erythematous rim. During the period of growth, it ulcerates and becomes similar to gummous syphilide. Metastasizes to the lymph nodes, causes an enlargement of the spleen, and when soft tissue is compressed, it causes severe pain.

According to the results of histology, it has an alveolar structure, even with reticular carcinoma. The connective tissue mesh contains round and spindle-shaped cells of the embryonic type, similar to megakaryocytes and myelocytes. In this case, the blood vessels are devoid of elastic tissue and are thinned. Treatment of polymorphic cell sarcoma is only surgical.

Undifferentiated sarcoma

Undifferentiated sarcoma is a tumor that is difficult or impossible to classify based on histology. This type of sarcoma is not associated with specific cells, but is usually treated like rhabdomyosarcoma. So, malignant tumors of uncertain differentiation include:

• Epithelioid and alveolar soft tissue sarcoma.
• Clear cell tumor of soft tissue.
• Intimal sarcoma and malignant mesenchymoma.
• Round cell desmoplastic sarcoma.
• Tumor with perivascular epithelioid cell differentiation (myomelanocytic sarcoma).
• Extrarenal rhabdoid neoplasm.
• Extraskeletal Ewing tumor and extraskeletal myxoid chondrosarcoma.
• Neuroectodermal neoplasm.

Histiocytic sarcoma

Histiocytic sarcoma is a rare malignant neoplasm of an aggressive nature. The tumor consists of polymorphic cells, in some cases it has giant cells with a polymorphic nucleus and pale cytoplasm. Histiocytic sarcoma cells are positive when tested for nonspecific esterase. The prognosis of the disease is unfavorable, as generalization occurs quickly.

Histiocytic sarcoma is characterized by a rather aggressive course and poor response to therapeutic treatment. This type of sarcoma causes extranodal lesions. This pathology affects the gastrointestinal tract, soft tissues and skin. In some cases, histiocytic sarcoma affects the spleen, central nervous system, liver, bones and bone marrow. When diagnosing the disease, immunohistological examination is used.

Round cell sarcoma

Round cell sarcoma is a rare malignant tumor consisting of round cell elements. The cells contain hyperchromic nuclei. Sarcoma corresponds to an immature state of connective tissue. The tumor progresses rapidly and is therefore extremely malignant. There are two types of round cell sarcoma: small cell and large cell (the type depends on the size of the cells that make up its composition).

According to the results of histological examination, the neoplasm consists of round cells with poorly developed protoplasm and a large nucleus. The cells are located close to each other and do not have a specific order. There are cells in contact and cells separated from each other by thin fibers and a pale-colored amorphous mass. Blood vessels are located in the connective tissue layers and tumor cells that are adjacent to its walls. The tumor affects the skin and soft tissues. Sometimes, with the lumen of the vessels, it is possible to see tumor cells that have invaded healthy tissue. The tumor metastasizes, recurs and causes necrosis of the affected tissues.

Fibromyxoid sarcoma

Fibromyxoid sarcoma is a neoplasm with a low degree of malignancy. The disease affects both adults and children. Most often, sarcoma is localized in the torso, shoulders and hips. The tumor rarely metastasizes and grows very slowly. The causes of fibromyxoid sarcoma include hereditary predisposition, soft tissue injuries, exposure to large doses of ionizing radiation and chemicals that have a carcinogenic effect. The main symptoms of fibromyxoid sarcoma:

• Painful lumps and tumors appear in the soft tissues of the torso and limbs.
• Painful sensations appear in the area of ​​the tumor and sensitivity is impaired.
• The skin becomes bluish-brown in color, and as the tumor grows, compression of the blood vessels and ischemia of the extremities occurs.
• If the neoplasm is localized in the abdominal cavity, then the patient experiences pathological symptoms from the gastrointestinal tract (dyspeptic disorders, constipation).

The general symptoms of fibromyxoid sarcoma manifest themselves in the form of unmotivated weakness, weight loss and lack of appetite, which lead to anorexia, as well as frequent fatigue.

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Lymphoid sarcoma

Lymphoid sarcoma is a tumor of the immune system. The clinical picture of the disease is polymorphic. Thus, in some patients, lymphoid sarcoma manifests itself in the form of enlarged lymph nodes. Sometimes tumor symptoms manifest themselves in the form of autoimmune hemolytic anemia, eczema-like rashes on the skin and poisoning. Sarcoma begins with a syndrome of compression of the lymphatic and venous vessels, which leads to dysfunction of organs. In rare cases, sarcoma causes necrotic lesions.

Lymphoid sarcoma has several forms: localized and local, widespread and generalized. From a morphological point of view, lymphoid sarcoma is divided into: large cell and small cell, that is, lymphoblastic and lymphocytic. The tumor affects the lymph nodes of the neck, retroperitoneal, mesenteric, and less commonly, axillary and inguinal. The neoplasm can also occur in organs that contain lymphoreticular tissue (kidneys, stomach, tonsils, intestines).

To date, there is no unified classification of lymphoid sarcomas. In practice, the international clinical classification is used, which was adopted for lymphogranulomatosis:

1. Local stage - lymph nodes are affected in one area and have extranodal localized lesions.
2. Regional stage – lymph nodes in two or more areas of the body are affected.
3. Generalized stage - the lesion has occurred on both sides of the diaphragm or spleen, and the extranodal organ is affected.
4. Disseminated stage - sarcoma progresses in two or more ectnonodal organs and lymph nodes.

Lymphoid sarcoma has four stages of development, each of which causes new, more painful symptoms and requires long-term chemotherapy for treatment.

Epithelioid sarcoma

Epithelioid sarcoma is a malignant tumor that affects the distal extremities. The disease most often occurs in young patients. Clinical manifestations indicate that epithelioid sarcoma is a type of synovial sarcoma. That is, the origin of the tumor is a controversial issue among many oncologists.

The disease gets its name from the round, large epithelial cells that resemble granulomatous inflammation or squamous cell carcinoma. The neoplasm appears as a subcutaneous or intradermal nodule or multinodular mass. The tumor appears on the surface of the palms, forearms, hands, fingers, and feet. Epithelioid sarcoma is the most common soft tissue tumor of the upper extremities.

Sarcoma is treated by surgical excision. This treatment is explained by the fact that the tumor spreads along the fascia, blood vessels, nerves and tendons. Sarcoma can give metastases - nodules and plaques along the forearm, metastases in the lungs and lymph nodes.

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Myeloid sarcoma

Myeloid sarcoma is a local neoplasm consisting of leukemic myeloblasts. In some cases, patients have acute myeloid leukemia before myeloid sarcoma. Sarcoma can act as a chronic manifestation of myeloid leukemia and other myeloproliferative lesions. The tumor is localized in the bones of the skull, internal organs, lymph nodes, tissues of the mammary glands, ovaries, gastrointestinal tract, tubular and spongy bones.

Treatment of myeloid sarcoma consists of chemotherapy and local radiation therapy. The tumor is amenable to anti-leukemic treatment. The tumor rapidly progresses and grows, which determines its malignancy. Sarcoma metastasizes and causes disruption in the functioning of vital organs. If sarcoma develops in blood vessels, then patients experience disturbances in the hematopoietic system and develop anemia.

Clear cell sarcoma

Clear cell sarcoma is a malignant fasciogenic tumor. The neoplasm is usually localized on the head, neck, torso and affects soft tissues. The tumor is dense round nodes, with a diameter of 3 to 6 centimeters. Upon histological examination, it was determined that the tumor nodes were gray-white in color and had an anatomical connection. Sarcoma develops slowly and is characterized by a long-term course of many years.

Sometimes, clear cell sarcoma appears around or inside the tendons. The tumor often recurs and metastasizes to the bones, lungs and regional lymph nodes. Sarcoma is difficult to diagnose; it is very important to differentiate it from primary malignant melanoma. Treatment can be carried out with surgical methods and radiation therapy methods.

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Neurogenic sarcoma

Neurogenic sarcoma is a malignant neoplasm of neuroectodermal origin. The tumor develops from the Schwann sheath of peripheral nerve elements. The disease occurs extremely rarely, in patients aged 30-50 years, usually on the extremities. According to the results of histological examination, the tumor is round, large-lumpy and encapsulated. Sarcoma consists of spindle-shaped cells, the nuclei are arranged in the form of a palisade, the cells are in the form of spirals, nests and bundles.

Sarcoma develops slowly, causes pain on palpation, but is well limited to the surrounding tissues. Sarcoma is located along the nerve trunks. Treatment of the tumor is only surgical. In particularly severe cases, excision or amputation is possible. Chemotherapy and radiation therapy methods are ineffective in the treatment of neurogenic sarcoma. The disease often recurs, but has a positive prognosis; survival rate among patients is 80%.

Bone sarcoma

Bone sarcoma is a rare malignant tumor of various locations. Most often, the disease appears in the area of ​​the knee and shoulder joints and in the pelvic bones. The cause of the disease may be an injury. Exostosis, fibrous dysplasia and Paget's disease are other causes of bone sarcoma. Treatment involves chemotherapy and radiation therapy.

Muscle sarcoma

Muscle sarcoma is very rare and most often affects younger patients. In the early stages of development, sarcoma does not manifest itself and does not cause painful symptoms. But the tumor gradually grows, causing swelling and pain. In 30% of cases of muscle sarcoma, patients experience abdominal pain, attributing this to problems with the gastrointestinal tract or menstrual pain. But soon, painful sensations begin to be accompanied by bleeding. If muscle sarcoma occurs on the extremities and begins to increase in size, then it is easiest to diagnose.

Treatment depends entirely on the stage of development of the sarcoma, size, metastasis and extent of spread. Surgical methods and radiation irradiation are used for treatment. The surgeon removes the sarcoma and some healthy tissue around it. Radiation is used both before and after surgery to shrink the tumor and kill any remaining cancer cells.

Skin sarcoma

Skin sarcoma is a malignant lesion, the source of which is connective tissue. As a rule, the disease occurs in patients aged 30-50 years. The tumor is localized on the trunk and lower extremities. The causes of sarcoma are chronic dermatitis, trauma, long-term lupus, and scars on the skin.

Skin sarcoma most often manifests itself in the form of solitary neoplasms. The tumor can appear both on intact dermis and on scarred skin. The disease begins with a small hard nodule, which gradually enlarges, acquiring irregular shape. The neoplasm grows towards the epidermis, growing through it, causing ulceration and inflammatory processes.

This type of sarcoma metastasizes much less frequently than other malignant tumors. But if the lymph nodes are affected, the patient’s death occurs after 1-2 years. Treatment of skin sarcoma involves the use of chemotherapy, but surgical treatment is considered more effective.

Lymph node sarcoma

Lymph node sarcoma is a malignant neoplasm that is characterized by destructive growth and arises from lymphoreticular cells. Sarcoma has two forms: local or localized, generalized or widespread. From a morphological point of view, sarcoma of the lymph nodes is: lymphoblastic and lymphocytic. Sarcoma affects the lymph nodes of the mediastinum, neck and peritoneum.

The symptomatology of sarcoma is that the disease grows rapidly and increases in size. The tumor is easily palpable, the tumor nodes are mobile. But due to pathological growth, they may acquire limited mobility. Symptoms of lymph node sarcoma depend on the degree of damage, stage of development, location and general condition of the body. The disease is diagnosed using ultrasound and x-ray therapy. In the treatment of lymph node sarcoma, methods of chemotherapy, radiation and surgical treatment are used.

Vascular sarcoma

Vascular sarcoma has several varieties, which differ in the nature of origin. Let's look at the main types of sarcomas and malignant tumors that affect blood vessels.

• Angiosarcoma

This is a malignant tumor that consists of a collection of blood vessels and sarcomatous cells. The tumor progresses rapidly, is capable of decay and profuse bleeding. The neoplasm is a dense, painful dark red node. In the initial stages, angiosarcoma can be mistaken for a hemangioma. Most often, this type of vascular sarcoma occurs in children over five years of age.

• Endothelioma

Sarcoma arising from the inner walls of a blood vessel. A malignant neoplasm has several layers of cells that can close the lumen of blood vessels, which complicates the diagnostic process. But the final diagnosis is made using histological examination.

• Perithelioma

Hemangiopericytoma originating from the outer choroid. The peculiarity of this type of sarcoma is that sarcomatous cells grow around the vascular lumen. The tumor may consist of one or several nodes of different sizes. The skin over the tumor turns blue.

Treatment of vascular sarcoma involves surgery. After surgery, the patient is given a course of chemotherapy and radiation to prevent relapse of the disease. The prognosis for vascular sarcomas depends on the type of sarcoma, its stage and method of treatment.

Metastases in sarcoma

Metastases in sarcoma are secondary foci of tumor growth. Metastases are formed as a result of the detachment of malignant cells and their penetration into the blood or lymphatic vessels. With the blood flow, the affected cells travel throughout the body, stopping anywhere and forming metastases, that is, secondary tumors.

The symptoms of metastases depend entirely on the location of the tumor. Most often, metastases occur in nearby lymph nodes. Metastases progress, affecting organs. The most common sites for metastases are bones, lungs, brain and liver. To treat metastases, it is necessary to remove the primary tumor and tissue from regional lymph nodes. After this, the patient undergoes a course of chemotherapy and radiation. If metastases reach large sizes, they are removed surgically.

Diagnosis of sarcoma

Diagnosis of sarcoma is extremely important, as it helps to establish the location of the malignant neoplasm, the presence of metastases, and sometimes the cause of the tumor. Diagnosis of sarcoma is a complex of various methods and techniques. The simplest diagnostic method is a visual examination, which includes determining the depth of the tumor, its mobility, size, and consistency. Also, the doctor should examine regional lymph nodes for the presence of metastases. In addition to visual examination, the following is used to diagnose sarcoma:

• Computed tomography and magnetic resonance imaging - these methods provide important information about the size of the tumor and its relationship with other organs, nerves and great vessels. Such diagnostics are carried out for tumors of the pelvis and extremities, as well as sarcomas located in the sternum and abdominal cavity.
• Ultrasonography.
• Radiography.
• Neurovascular examination.
• Radionuclide diagnostics.
• Biopsy is the removal of sarcoma tissue for histological and cytological studies.
• Morphological examination is carried out to determine the stage of sarcoma and choose treatment tactics. Allows you to predict the course of the disease.

We should not forget about timely treatment of specific inflammatory diseases that can take a chronic form (syphilis, tuberculosis). Hygienic measures are a guarantee of the normal functioning of individual organs and systems. Treatment of benign tumors that can develop into sarcomas is mandatory. And also, warts, ulcers, lumps in the mammary gland, tumors and stomach ulcers, erosions and fissures of the cervix.

Prevention of sarcoma should include not only the implementation of the methods described above, but also undergoing preventive examinations. Women should visit a gynecologist every 6 months to identify and promptly treat lesions and diseases. Don’t forget about undergoing fluorography, which allows you to identify lesions in the lungs and chest. Compliance with all the methods described above is an excellent prevention of sarcoma and other malignant tumors.

Sarcoma prognosis

The prognosis of sarcoma depends on the location of the tumor, the origin of the tumor, the growth rate, the presence of metastases, the volume of the tumor and the general condition of the patient’s body. The disease is classified according to its degree of malignancy. The higher the degree of malignancy, the worse the prognosis. Do not forget that the prognosis also depends on the stage of sarcoma. In the first stages, the disease can be cured without harmful consequences for the body, but the last stages of malignant tumors have a poor prognosis for the patient’s life.

Despite the fact that sarcomas are not the most common oncological diseases that can be treated, sarcomas are prone to metastasis, affecting vital organs and systems. In addition, sarcomas can recur, again and again affecting a weakened body.

Sarcoma survival rate

Survival from sarcoma depends on the prognosis of the disease. The better the prognosis, the higher the patient's chances for a healthy future. Very often, sarcomas are diagnosed in the last stages of development, when the malignant tumor has already metastasized and affected all vital organs. In this case, patient survival ranges from 1 year to 10-12 years. Survival also depends on the effectiveness of treatment; the more successful the treatment, the greater the likelihood that the patient will live.

Sarcoma is a malignant tumor that is rightfully considered the cancer of young people. Everyone is susceptible to the disease, both children and adults. The danger of the disease is that at first, the symptoms of sarcoma are insignificant and the patient may not even know that his malignant tumor is progressing. Sarcomas are diverse in their origin and histological structure. There are many types of sarcomas, each of which requires a special approach to diagnosis and treatment.