What is Soft Tissue Cancer (Sarcoma)?

Sarcomas are called "soft tissue sarcoma" if they occur in soft tissues, bone sarcoma or "osteosarcoma" if they occur in bones.

What is Sarcoma (Soft Tissue Cancer)?

Sarcoma is a rare type of cancer that originates from the connective tissue. Connective tissue is a system that connects and supports tissues in the body. Sarcomas can occur in bones, muscles, tendons, nerves, cartilage, fatty tissue, or blood vessels. There are more than seventy types of sarcoma.
Sarcomas are more common in childhood. It is rare in adults. Sarcomas constitute 15% of childhood cancers.
Sarcomas are more common in the arms and legs, abdomen and head and neck, in order of frequency.

What are the Symptoms of Soft Tissue Cancer?

The most common symptoms:

• Painful or painless lump formation in any part of the body,
• Bone pain,
• Severe bone fracture in a very mild trauma,
• Abdominal pain,
• Weight loss.

What are the Causes of Sarcoma?

It is not known why sarcoma type cancers occur. However, mutations in DNA are thought to be responsible for the development of sarcoma. Examples of this situation are retinoblastoma (tumor of the eye) and neurofibromatosis type 1.

Radiation for cancer: Cancer patients who receive radiotherapy may develop sarcoma later on.

Lymphedema: Due to a disorder in the lymphatic system It is a disease characterized by excessive swelling in the involved area. Angiosarcoma may develop in patients with lymphedema.

Chemicals: Some industrial chemicals and pesticides may increase the risk of liver-borne sarcoma.

Viruses: The virus called Human Herpes virus 8, Kaposi's sarcoma in people with weakened immune systems

What are the Types of Soft Tissue Cancer (Sarcoma)?

• Angiosarcoma: affects lymph vessels.
• Gastrointestinal stromal tumor: This affects special neuromuscular cells of the intestine.
• Liposarcoma: This is a fatty tissue sarcoma that's it. These usually start in the thigh, behind the knee, or behind the abdomen.
• Leiomyosarcoma: This is caused by smooth muscles in the organ walls. It is usually seen in the abdominal wall.
• Synovial sarcoma: It is a tumor of stem cells. Cancerous tissue may develop around the joints.
• Neurofibrosarcoma: This type affects the protective lining of the nerves.
• Rhabdomyosarcoma: It occurs in skeletal muscle.
• Fibrosarcomas: These are fibroblasts, which are cells in the connective tissue.
• Myxofibrosarcoma: Affects connective tissue and often develops in the arms and legs of older adults.
• Mesenchymomas: These are rare and combine elements of other sarcomas. They can occur in any part of the body.
• Vascular sarcoma: This type occurs in blood vessels.
• Schwannoma: It affects the tissues lining the nerves.
• Kaposi's sarcoma: This type mainly affects the skin, but can occur in other tissues. It is caused by the human herpes virus 8. It is a malignant tumor of the tissue surrounding the lymphatic vessels in the skin. In Kaposi's sarcoma, tumors occur in the skin and internal organs. Tumors on the skin start as purple spots and become puffy from the skin over time.

Kaposi's sarcoma can start in different regions at the same time. Herpes virus 8 was detected in the examinations performed on the tumors of the patients. Kaposi's sarcoma occurs especially in patients whose immune system is suppressed due to AIDS and organ transplantation.
Types of Kaposi's sarcoma:

• Classical Kaposi's sarcoma
• African Kaposi's sarcoma
• Immunosuppression-related
• Kaposi's sarcoma
• Epidemic Kaposi's sarcoma
• Non-epidemic Kaposi's sarcoma.

Lung film for diagnosis , endoscopy, skin biopsy, and bronchoscopy can be performed.
Kaposi's sarcoma spreads through lymph and blood. The course of the disease varies according to the type and extent of the cancer.

Classical Kaposi's sarcoma is more common in older men. In these patients, tumor localization is common in the feet and legs. Tumors grow slowly, have a brown-purple color. It can spread to other organs over time.

Radiotherapy, surgery, chemotherapy and biological treatments are applied according to the type and extent of the disease. Antiretroviral therapy is necessary in HIV-positive patients .

• Bone sarcoma

Osteosarcoma: The type of sarcoma involving the bone is called osteosarcoma. It is common in children and adolescents. Osteosarcoma is the most common malignant bone tumor in children. In osteosarcoma, mutations have been detected in the 13th and 17th chromosomes of the patients. Osteosarcoma often occurs in long bones. The main finding in most patients is pain. A palpable mass is present in half of the cases. Movement restriction and weakness in the extremity (limbs) may be seen in the affected area. It can metastasize in 15%. The most common metastases are to the lungs, other bones, and the brain.

Ewing's sarcoma: This can occur in bone or soft tissue. Ewing sarcoma is most common between the ages of 5-20. A large soft tissue mass and bone destruction are observed. It most commonly occurs in the arms and legs, pelvis and ribs in the body

Chondrosarcoma: It starts in the cartilage.

Fibrosarcoma: This occurs in the fibrogenic tissue, which is a type of connective tissue.

How Are Soft Tissue Cancers Diagnosed?

If you have a palpable mass in your body, your doctor may find a biopsy appropriate. Biopsy is of great importance for determining the type and staging of the tumor. Biopsy can be done directly, under ultrasound or with tomography. Soft tissue sarcomas are best visualized with MRI. Direct radiography, tomography, PET, bone scan and ultrasound may be requested from the patient when appropriate.
In osteosarcoma, serum alkaline phosphate in the blood is high in 50% of the patients and serum lactate dehydrogenase (LDH) is high in 25% of the patients. Direct radiography makes the diagnosis. (In the radiographic image, there is a lytic and sclerotic lesion with bone formation and destruction together).

How is Soft Tissue Cancer Treated?

The most common treatment is surgery. The surgeon removes the tumor and surrounding tissues. It also takes a sample to send to pathology. Radiotherapy can be applied after surgery. Radiotherapy is sometimes used initially to shrink the tumor. If the patient is not suitable for surgery, only radiotherapy can be given. In the treatment of sarcoma, chemotherapy can be used with or instead of surgery.
In the targeted therapies that have been put into practice in recent years, the healthy cells of the body are preserved and the treatment is directed towards the tumor directly. immunotherapy, immune system Mini is a drug therapy that uses it to fight cancer. Ablation therapy is a treatment method that destroys cancer cells by applying electricity to heat cells, very cold liquid to freeze cells, or high-frequency ultrasound waves to damage cells.
Sarcomas are divided into 4 stages according to their spread. In stages 1 and 2, the tumor is regional. In stage 3, the tumor has spread to the lymph nodes in the area where it is located. In stage 4, it has metastasized to distant organs.

Are There Any Tumor-like Conditions in Soft Tissue?

Some changes in soft tissues are caused by inflammation or injury and may form a mass that resembles a soft tissue tumor. Unlike a true tumor, they do not come from a single abnormal cell, have limited ability to grow or spread to nearby tissues, and never spread through the bloodstream or lymph system to other parts of the body.

Who Treats Sarcoma?

A team of orthopedists, surgeons, medical oncologists, radiation oncologists and pathologists performs the treatment and follow-up of sarcoma, ie soft tissue cancers.
If there is an individual in your family who shows the symptoms mentioned above, you can apply to the nearest health institution to evaluate treatment options. We wish you healthy days.

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