Soft tissue sarcoma
Soft tissue sarcoma - a group of mesenchymal malignancies nature.From all common in adult cancers, soft tissue sarcoma is only 1%.Tumor equally affects men and women, usually between twenty fifty years.The structure of the soft tissues of the trunk and limbs includes tendons, fascia, intermuscular and subcutaneous fat, and intramuscular connective okolososudistye layer, a shell of peripheral nerves, striated muscle and synovial tissue.
are the following types of soft tissue sarcomas: angiosarcoma, alveolar soft tissue sarcoma, chondrosarcoma extraskeletal, epithelioid sarcoma, leiomyosarcoma, fibrosarcoma, malignant fibrous histiocytoma, liposarcoma, malignant haemangiopericytoma, malignant schwannoma, malignant mezenhimoma, synovial sarcoma and rhabdomyosarcoma.
division of soft tissue sarcoma of grade:
• High degree of malignancy.The cells are poorly differentiated, they observed a rapid active division.Sarcoma abundantly provided with blood vessels, there is a lot o
• Low degree of malignancy.In such sarcoma cells exhibit low mitotic activity and highly differentiated, contain many small and stromal tumor cells.Necrosis very little blood supply to the tumor slightly
Soft tissue sarcoma - Causes
Significant causes of soft tissue sarcoma has not yet been determined, but rather clearly defined range of factors that increase the likelihood of developing these tumors.Risk factors include: the impact of various chemical carcinogens, genetic predisposition, some viruses (HIV, herpes virus), the effects of radiation and radiation, impaired immune defense, environmental hazards, frequent injuries.
addition to this, soft tissue sarcoma can develop due to the presence in humans of diseases such as disease of Recklinghausen (developing neyrofibrosarkoma) and Paget's disease (developing osteosarcoma)
Soft tissue sarcoma - symptoms
Even despite the fact that under the definition"soft tissue sarcoma" is hiding a group of neoplasms, for all of them it is still possible to identify some common symptoms:
- neoplasm observed visually.With progression, sarcoma becomes visible to the naked eye.There has been its impact on nearby organs, resulting in violation of their proper functioning
- Pain.Pain is a rare initial symptom, and appears only when the affected tumor of the nerve fibers
- Fatigue, weakness
- rapid weight loss
- The skin over the tumors may ulcerate and change your color
Unfortunately, most of the aboveSymptoms appear in the later stages of the disease, when the precious time lost.
Soft tissue sarcoma can develop anywhere on the body.In about 50% of patients it is localized in the lower extremities, usually on the femoral part.On the upper extremities sarcoma observed in 25% of patients.The remaining cases occur in the body and very rarely on the head.
Soft tissue sarcoma looks smooth or rough yellowish-gray or off-white circular assembly.Consistency tumors depends on its histological structure.Sarcoma can be jelly-like (myxoma), soft (hemangiosarcoma, liposarcoma) and dense (fibrosarcoma).Soft tissue sarcomas have no true capsule, but the growth of malignancies squeezes the surrounding tissue, which thereby condense to form a clearly delimited tumor false capsule.
sarcoma most often occurs in the deep layers of muscles and the growth starts to gradually move to the surface of the body.Under the influence of physiotherapy and injury significantly accelerated its growth.In most cases there is a single tumor, but possible, and multiple lesions.They often occur at a sufficiently great distance from each other (malignant neuroma, multiple liposarcoma).
main route for metastatic soft tissue sarcoma is a circulatory system, and the favorite localization of metastases - Lightweight (less bone and liver).In 8% of cases metastasis to the lymphatic system.A feature of malignant tumors of soft tissues is considered to be the existence of a whole group of tumors, which are a kind of intermediary between malignant and benign.These tumors often recur, have mestnoretsidiviruyuschim infiltrative growth, rarely metastasize (differentiated fibrosarcoma, embryonic or fibroids and intermuscular lipomas, desmoid tumors of the abdominal wall), or do not give metastases in general.
leading sign of soft tissue sarcoma is the appearance of swelling or a small knot oval or round shape.Dimensions tumors can range from two to thirty centimeters.When pronounced false capsule tumor borders clear, in the case of deep-lying tumors, hard to define the contours and indistinct.The skin is usually not changed, but in the rapidly growing massive reached the surface of tumors appear mesh extended saphenous veins, there is a local increase in temperature, there may be infiltration or ulceration of the skin.On palpation the tumor inactive.Sometimes soft tissue sarcoma leads to a significant deformation of limbs during movement evokes a feeling of unease and severity, but full function of the limb almost never violated.
diagnosis of soft tissue sarcoma in the early stages is extremely difficult, but there are so-called "alarm", by the knowledge that a person can promptly seek qualified help.So suspicion of sarcoma can be if:
- appears gradually increasing a tumor
- The tumor is almost stationary
- Appears tumor originating from deep layers of soft tissue
- After an injury for several weeks to two or threeyears there swelling
After a visit to a doctor, a specialist queries, conducting a general inspection and assigns a specific range of studies: ultrasound (to evaluate the size of the tumor and the degree of involvement in the pathological process of adjacent tissues), radiography (identifies tumor and determines its shape and size), CT (allows you to display layered sections of the tumor and simulates a three-dimensional model of tumors), MRI, scintigraphy, positron emission tomography
Soft tissue sarcoma - treated
Treatment of soft tissue sarcoma is always complex, is wide excision of malignant tumors in conjunction withchemotherapy and radiotherapy.The leading member of the radical treatment is surgery, depth and scope of which depends on the location and extent of tumor spread.When performing a standard operation performed wide excision of education within the anatomic zones.When tumors intermuscular spaces together to form removed portions adjacent muscles.In the case of tumor invasion of great vessels, bones or nerve trunks, as well as in the case of unsuccessful repeated intact operations carried limb amputation.Besides resorting to amputation in cases of advanced forms of cancer, which are accompanied by unbearable pain or complicated by bleeding and decay.
As a complement surgical treatment applied radiation therapy.For small-sized entities, reducing the risk of recurrence is shown postoperative irradiation.It is also well established itself preoperative irradiation, which is used in large-sized tumors, which greatly facilitates the removal process.Brachytherapy is a kind of radiation and the irradiation is applied directly to the tumor itself through the movement of the source with radioactive material inside it.With this method the adjacent tissue damage observed during the irradiation distance, at times reduced.
chemotherapy in the treatment of soft tissue sarcoma has become widely used only in recent years.Thanks to adjuvant chemotherapy after surgery the risk of metastasis and recurrence is significantly reduced.The most effective drugs are considered Adriamycin (30% of patients causes a remission).
If soft tissue sarcoma was found in the early stages, the prognosis favorable treatment.Carrying out comprehensive treatment allows 75% of patients achieved a five-year survival rate.In the case of extensive spread of malignant process and application on the subject of aggressive combination therapy, the five-year survival rate is less than 35%.