Sarcoma

Sarcoma

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Sarcoma, Soft Tissue Sarcoma

  • See Also
  1. Soft Tissue Mass
  • Definitions
  1. Sarcoma
    1. Cancer arrising in mesenchymal (connective) tissue
    2. Tumors may originate from bones, fat, Muscle, vessels or Lymphatics
    3. Derived from greek word "sar" meaning fleshy
  • Epidemiology
  1. Age
    1. More common in adults over age 35 years (but represent <1% of adult cancers)
    2. Sarcomas represent 10-15% of childhood malignancy (esp. in extremities)
      1. Soft Tissue Sarcomas are the sixth most common Childhood Cancer (esp. rhabomyosarcoma)
  • Types
  1. Soft-tissue Sarcomas
    1. Kaposi's Sarcoma
    2. Hepatic angiosarcoma
    3. Dermatofribosarcoma Protuberans
    4. Synoviosarcoma
    5. Rhabdomyosarcoma
      1. Most common Soft Tissue Sarcoma in children (esp. age <8 years old)
      2. Account for 60% of pediatric tumors of the head and neck
    6. Leiomyosarcoma
      1. Involves Uterus in adults
      2. Involves Retroperitoneum in children
    7. Liposarcoma
      1. Rare adipose tumor (usually invades locally only)
      2. Involves deep thigh or Retroperitoneum
    8. Fibrosarcoma
      1. Most common Soft Tissue Sarcoma in age <1 year
      2. Involves deep thigh or Retroperitoneum
  2. Vascular Sarcoma
    1. Angiosarcoma (Stewart-Treves Syndrome)
      1. Malignancy of blood vessels and lymph vessels
      2. Presents with red to violaceous skin Papules
      3. May invade deeper tissue with tumor growth, leading to ulceration, edema, bleeding
    2. Hemangioendothelioma
    3. Hemangiopericytoma
  3. Bone Tumors
    1. Ewing's Sarcoma
    2. Osteogenic Sarcoma
  • Precautions
  1. See Soft Tissue Mass for red flag findings
  2. Delayed presentation is common (often >1 month from finding a Soft Tissue Mass)
  3. Most Soft Tissue Sarcomas gradually enlarge without pain or constitutional symptoms
  • Evaluation
  1. See Soft Tissue Mass (includes red flag findings and imaging)
  • Prognosis
  1. Five year survival: 60%
    1. Ranges between Stage 1 (five year survival 80%) and Stage 4 (five year survival 20%)
  • References
  1. Hanback and Kosoko (2023) Crit Dec Emerg Med 37(4): 14-5
  2. Achar (2022) Am Fam Physician 105(6): 602-12 [PubMed]