Author: Carol D. Morris, MD, MS
Description
Soft tissue sarcoma (STS) refers to a group of cancers arising from the connective tissue (muscle, fat, etc.). They most commonly arise in the extremities but can grow virtually anywhere in the body. While STS is more common in older adults, they can occur in any age including infants. There are over 100 types of STS. Some of the most common include liposarcoma, fibrosarcoma, rhabdomyosarcoma, and synovial sarcoma.
Symptoms
Patients typically present with a lump or bump (Figure 1). Often patients sense that the mass is growing though this is not universal. The mass is typically not painful. While patients often report a prior history of trauma to the area, it is believed that the trauma drew attention to the area as opposed to causing the mass to appear.
Examination
Palpation of the area most often reveals a firm non-mobile fullness. Again, the mass is not typically painful to touch.
Tests
Imaging of the affected area can include x-rays, MRI, CT scan, and ultrasound. Of these, MRI (Figure 2) provides the most information by providing anatomic details and characteristics about the mass. When a STS is suspected, a needle biopsy is most often performed to obtain tissue for diagnosis. Once the diagnosis is confirmed, patients are often sent to centers that specialize in the management of sarcoma. A multidisciplinary team consisting of orthopedic oncologists (surgeons), radiation oncologists, and medical oncologists create plans specific to treat the tumor. Almost all tumors will need surgery to remove them. The need for additional treatments such as radiation therapy or chemotherapy are dependent on the stage of disease.
Images
Figure 1: Clinical picture of a soft tissue mass of the forearm.
Figure 2: MRI picture of a soft tissue sarcoma of the thigh. The image is a cross section of the middle of the thigh. The star is on the femur bone. The arrow points to the STS.
Prognosis
Prognosis for all cancers depends on the stage of disease. Staging for STS takes 3 things into account: 1. Size of the mass; 2. Grade (appearance under the microscope); 3. Metastasis (whether the tumor has traveled to another part of the body). In general, the lower the grade the better the prognosis. Due to its complexity and rarity, it is highly recommended that patients are treated by an orthopaedic oncologist who has experience treating these tumors.
More Information:
American Cancer Society: https://www.cancer.org/cancer/types/soft-tissue-sarcoma/about.html
Sarcoma Alliance: https://sarcomaalliance.org/
This is not intended as a substitute for professional medical advice and does not provide advice on treatments or conditions for individual patients. All health and treatment decisions must be made in consultation with your physician(s), utilizing your specific medical information. Inclusion in this is not a recommendation of any product, treatment, physician or hospital.