Sarcoma

Sarcoma is a disease that involves malignant neoplasms of various localizations. Let's look at the main types of sarcoma, the 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, vessels, muscles, tendons, etc. Among all forms of sarcoma, especially malignant ones account for about 15% of neoplasms.

Read also: Treatment of sarcoma

The main symptoms of the disease are swelling of some part of the body or node. Sarcoma affects: smooth and striated muscle tissue, bones, nervous, fatty and fibrous tissue. The diagnostic methods and treatment methods depend on the type of disease. The most common types of sarcoma are:

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

Sarcoma affects connective and soft tissues. In 60% of cases, the tumor develops on the upper and lower extremities, in 30% on the trunk, and only in rare cases, sarcoma affects the tissues of the neck and head. The disease occurs in both adults and children. At the same time, about 15% of sarcoma cases are cancerous diseases. Many oncologists consider sarcoma 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 damage to smooth muscle tissue is leiomyosarcoma.

ICD-10 code

Sarcoma ICD 10 is a classification of the disease according to the International Catalog of Diseases of the Tenth Revision.

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 retroperitoneum and peritoneum.
• C49 Malignant neoplasm of other connective and soft tissue.

Each of the points has its own classification. Let's consider what each of the categories of the international classification of diseases 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 - a tumor that develops from blood vessels. The peculiarity of the neoplasm is the appearance of red-brown spots on the skin with distinct edges. The disease is malignant, therefore it poses a threat to human life.
• Malignant neoplasm of peripheral nerves and autonomic nervous system - this category includes lesions and diseases of the peripheral nerves, lower extremities, head, neck, face, chest, and hip area.
• Malignant neoplasm of the retroperitoneal space and peritoneum - soft tissue sarcomas affecting the peritoneum and retroperitoneal space, causing thickening of parts of the abdominal cavity.
• 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.

Causes of sarcoma

The causes of sarcoma are varied. The disease can arise due to the influence of environmental factors, injuries, genetic factors and many other things. It is simply impossible to specify the cause of sarcoma development. However, several risk factors and causes are identified 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).
• Effect 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, suppurations, exposure to foreign bodies (splinters, 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

The 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 formation that gradually increases in size. So, if a patient has bone sarcoma, that is, osteosarcoma, 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 primary 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 painful sensations upon palpation.
• In 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 painful sensations. The tumor size can be from 2 to 30 centimeters.

Depending on the type of sarcoma, fever may occur. If the neoplasm progresses rapidly, subcutaneous veins appear on the skin surface, the tumor becomes cyanotic, and ulcers may appear on the skin. When palpating the sarcoma, tumor mobility is limited. If the sarcoma appears on the extremities, this may 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 lymphosarcomas and lymphogranulomatosis, tumors in the central nervous system, osteosarcomas, soft tissue sarcomas, tumors of the liver, stomach, esophagus and other organs.

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

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

• 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, 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, children under 10 years of age suffer from this disease. 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 the action of irritants and viruses that cause certain diseases. With a tumor disease, the lymph nodes increase in size, but are absolutely painless when palpated, the skin over the tumor does not change color.

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

• Lymphosarcoma

A malignant disease that occurs in 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 often, 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 malaise. As the sarcoma progresses, the patient complains of facial swelling and shortness of breath. The disease is diagnosed using X-ray or ultrasound. Treatment can be surgical, chemotherapy, and radiation.

• Kidney tumors

Kidney tumors are malignant neoplasms that are usually congenital and appear in patients at an early age. The true causes of kidney tumors are unknown. Sarcomas, leiomyosarcomas, and myxosarcomas occur on the kidneys. Tumors can be round cell carcinomas, lymphomas, or myosarcomas. Most often, the kidneys are affected by spindle-shaped, round cell, and mixed types of sarcomas. 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.

Surgical treatments are usually used to treat kidney tumors. Let's look at some of them.

• Radical nephrectomy – the doctor makes an incision in the abdominal cavity and removes the affected kidney and the fatty tissues surrounding it, 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 are: large size of the malignant tumor, metastasis to the regional lymph nodes.
• Laparoscopic surgery – the advantages of this method of treatment are obvious: minimally invasive, short recovery period after surgery, less pronounced postoperative pain syndrome and better aesthetic results. During the operation, several small punctures are made in the abdominal skin, through which a video camera is inserted, thin surgical instruments are introduced and the abdominal cavity is pumped with air to remove blood and excess tissue from the surgical area.
• Ablation and thermal ablation are the most gentle methods 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 are: thermal (laser, microwave, ultrasound), chemical (ethanol injections, electrochemical lysis).

Types of sarcoma

Types of sarcoma depend on the location of the disease. Depending on the type of tumor, certain diagnostic and treatment methods 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 grade.
• G2 - average degree.
• G3 - high and extremely high degree.

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

• Alveolar sarcoma – most often occurs in children and adolescents. Rarely metastasizes and is a rare type of tumor.
• Angiosarcoma - affects the skin vessels and develops from blood vessels. Occurs in internal organs, often after radiation.
• Dermatofibrosarcoma is a type of histiocytoma. It is a malignant tumor that arises from connective tissue. It most often affects the body and grows very slowly.
• Extracellular chondrosarcoma is a rare tumor that arises from cartilage tissue, is localized in the cartilage and grows into the bones.
• Hemangiopericytoma is a malignant tumor of blood vessels. It has the appearance of nodes and most often affects patients under 20 years of age.
• Mesenchymoma is a malignant tumor that grows from vascular and fatty tissue. It affects the abdominal cavity.
• Fibrous histiocytoma is a malignant tumor localized on the extremities and closer to the body.
• 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 the processes of neurons.
• 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, localized on the trunk and lower limbs.
• Lymphangiosarcoma - affects the lymphatic vessels, most often occurs in women who have undergone a mastectomy.
• Rhabdomyosarcoma – arises from striated muscles and develops in both adults and children.

There is a category of sarcoma without additional characteristics. This category includes:

• Kaposi's sarcoma - usually caused by the herpes virus. Often found in patients taking immunosuppressants and HIV-infected. The tumor develops from the dura mater, hollow and parenchymatous internal organs.
• Fibrosarcoma – occurs on ligaments and muscle tendons. Very often affects the feet, less often – the head. The tumor is accompanied by ulcers and actively metastasizes.
• Epithelioid sarcoma - affects the peripheral parts of the extremities, in young patients. The disease actively metastasizes.
• Synovial sarcoma - occurs in articular cartilage and around joints. It can develop from the synovial membranes of the sheath muscles and spread to 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. As a rule, 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 presumptive sign of sarcoma is undergoing a course of radiation therapy to treat pathologies in the pelvic area.

Stromal sarcoma is mainly diagnosed in patients aged 40-50 years, and during menopause, sarcoma occurs in 30% of women. The main symptoms of the disease are bloody discharge from the genital tract. Sarcoma causes painful sensations due to the enlargement of the uterus and compression of its neighboring organs. In rare cases, stromal sarcoma is asymptomatic, and it 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. Tumor nodes have a dense consistency, when cut, a fibrous structure of white-gray color is visible. Spindle cell sarcoma appears on mucous membranes, skin, serous covers and fascia.

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

Malignant sarcoma

Malignant sarcoma is a soft tissue tumor, i.e. 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 over several months.
• The location of the sarcoma in the pseudocapsule and frequent growth beyond its limits.

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 limbs. When performing an ultrasound examination, the tumor does not have clear contours, can be adjacent to the bone or cover the vessels and tendons of the muscles.
• 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 soft tissues. Sarcoma develops from intermuscular fascial formations. It metastasizes to the lungs and is most often found 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, thigh tissue, buttocks, retroperitoneal space, 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. It is localized on the lower extremities. The tumor contains blood cysts, which become a focus 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 extremities and develops in the thickness of the muscles as a node. When palpated, it is soft with a dense consistency. In some cases, it causes hemorrhages and necrosis. Sarcoma is quite painful, metastasizes to the lymph nodes and lungs.
• Synovial sarcoma is a malignant tumor of soft tissues, found in patients of all ages. As a rule, it is localized on the lower and upper limbs, in the area of the knee joints, feet, thighs, and shins. The tumor has the form of a round node, limited from the surrounding tissues. Inside the formation there are cysts of different sizes. Sarcoma recurs and can metastasize even after a course of treatment.
• Malignant neurinoma 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. It rarely metastasizes, and can metastasize to the lungs and lymph nodes.

Pleomorphic sarcoma

Pleomorphic sarcoma is a malignant tumor that affects the lower limbs, trunk, and other areas. 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 lobular, dense node, reddish-gray in color. The node contains a zone of hemorrhage and necrosis.

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

Polymorphic cell sarcoma

Polymorphonuclear sarcoma is a rather rare autonomous type of primary skin sarcoma. The tumor usually develops along the periphery of soft tissues, rather than in depth, and is surrounded by an erythematous rim. During the period of growth, it ulcerates and becomes similar to gummatous syphilid. It metastasizes to the lymph nodes, causes an enlarged spleen, and causes severe pain when soft tissues are compressed.

According to histology, it has an alveolar structure, even with reticular carcinoma. The connective tissue network contains round and spindle-shaped cells of the embryonic type, similar to megakaryocytes and myelocytes. At the same time, the blood vessels are deprived 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 as rhabdomyosarcomas. Thus, malignant tumors of indeterminate differentiation include:

• Epithelioid and alveolar soft tissue sarcoma.
• Clear cell tumor of soft tissue.
• Intimal sarcoma and mesenchymoma of malignant type.
• 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 giant cells with a polymorphic nucleus and pale cytoplasm. Histiocytic sarcoma cells are positive when tested for non-specific esterase. The prognosis of the disease is unfavorable, since generalization occurs quickly.

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

Round cell sarcoma

Round cell sarcoma is a rare malignant tumor consisting of round cellular elements. The cells contain hyperchromic nuclei. Sarcoma corresponds to an immature state of connective tissue. The tumor progresses rapidly, so it is 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 it up).

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, have no specific order. There are touching cells and cells separated from each other by thin fibers and a pale amorphous mass. Blood vessels are located in connective tissue layers and tumor cells that are adjacent to its walls. The tumor affects the skin and soft tissues. Sometimes, when opening the vessels, it is possible to see tumor cells that have penetrated healthy tissues. The tumor metastasizes, recurs and causes necrosis of the affected tissues.

Fibromyxoid sarcoma

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

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

General symptoms of fibromyxoid sarcoma include unmotivated weakness, weight loss and loss 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 as enlarged lymph nodes. Sometimes the symptoms of the tumor manifest themselves as autoimmune hemolytic anemia, eczema-like rashes on the skin and poisoning. Sarcoma begins with a syndrome of compression of 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, i.e. lymphoblastic and lymphocytic. The tumor affects the lymph nodes of the neck, retroperitoneal, mesenteric, less often - axillary and inguinal. The neoplasm can also occur in organs that contain lymphoreticular tissue (kidneys, stomach, tonsils, intestines).

There is currently no single classification of lymphoid sarcomas. In practice, the international clinical classification, which was adopted for lymphogranulomatosis, is used:

1. Local stage – the lymph nodes in one area are affected, with extranodal localized damage.
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 an extranodal organ is affected.
4. Disseminated stage – sarcoma progresses to two or more extranodal 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 affecting the distal parts of the extremities. The disease is most often found in young patients. Clinical manifestations indicate that epithelioid sarcoma is a type of synovial sarcoma. That is, the origin of the neoplasm is a controversial issue among many oncologists.

The disease got its name from the round cells, large epithelioid form, which resemble granulomatous inflammatory process 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, feet. Epithelioid sarcoma is the most common tumor of the soft tissues 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 metastasize - nodules and plaques along the forearm, metastasis in the lungs and lymph nodes.

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Myeloid sarcoma

Myeloid sarcoma is a localized neoplasm consisting of leukemic myeloblasts. In some cases, before myeloid sarcoma, patients have acute myeloblastic leukemia. 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, in tubular and spongy bones.

Treatment of myeloid sarcoma involves chemotherapy and local radiation therapy. The tumor responds to antileukemic treatment. The tumor progresses and grows rapidly, which is what causes its malignancy. Sarcoma metastasizes and causes disruptions in the functioning of vital organs. If sarcoma develops in blood vessels, patients experience disruptions 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, trunk and affects soft tissues. The tumor is dense round nodes, 3 to 6 centimeters in diameter. Histological examination revealed that the tumor nodes are gray-white in color and have an anatomical connection. Sarcoma develops slowly and is characterized by a long-term course.

Sometimes, clear cell sarcoma appears around or inside tendons. The tumor often recurs and metastasizes to bones, lungs, and regional lymph nodes. Sarcoma is difficult to diagnose and must be differentiated from primary malignant melanoma. Treatment can be surgical and radiation therapy.

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Neurogenic sarcoma

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

The sarcoma develops slowly, causes painful sensations when palpated, but is well limited by surrounding tissues. The sarcoma is located along the nerve trunks. The tumor is treated only surgically. In particularly severe cases, excision or amputation is possible. Chemotherapy and radiation therapy are ineffective in the treatment of neurogenic sarcoma. The disease often recurs, but has a positive prognosis, the survival rate among patients is 80%.

Bone sarcoma

Bone sarcoma is a rare malignant tumor of various localizations. Most often, the disease appears in the area of the knee and shoulder joints and in the area of the pelvic bones. The cause of the disease may be an injury. Exostoses, fibrous dysplasia and Paget's disease are another cause 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 painful sensations. In 30% of cases of muscle sarcoma, patients feel abdominal pain, associating this with problems with the gastrointestinal tract or menstrual pain. But soon, the painful sensations begin to be accompanied by bleeding. If muscle sarcoma has arisen on the limbs and begins to increase in size, then it is easiest to diagnose.

Treatment depends entirely on the stage of the sarcoma, its size, metastasis, and extent of spread. Surgical methods and radiation 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 originating from 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 skin scars.

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

This type of sarcoma metastasizes much less frequently than other malignant tumors. But if the lymph nodes are affected, the patient dies within 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 characterized by destructive growth and arising from lymphoreticular cells. Sarcoma has two forms: localized or localized, generalized or widespread. From a morphological point of view, lymph node sarcoma is: lymphoblastic and lymphocytic. Sarcoma affects the lymph nodes of the mediastinum, neck and peritoneum.

The symptoms of sarcoma are that the disease grows rapidly and increases in size. The tumor is easily palpated, the tumor nodes are mobile. But due to pathological growth, they can acquire limited mobility. The symptoms of lymph node sarcoma depend on the degree of damage, stage of development, localization and general condition of the body. The disease is diagnosed using ultrasound and X-ray therapy. Chemotherapy, radiation and surgical treatment are used in the treatment of lymph node sarcoma.

Vascular sarcoma

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

• Angiosarcoma

This is a malignant tumor that consists of a cluster 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 hemangioma. Most often, this type of vascular sarcoma occurs in children over five years of age.

• Endothelioma

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

• Perithelioma

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

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

Metastases in sarcoma

Metastases in sarcoma are secondary foci of tumor growth. Metastases are formed as a result of malignant cells breaking away and penetrating into blood or lymphatic vessels. With the blood flow, the affected cells travel around the body, stopping at any place 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 places for metastases to appear are bones, lungs, brain, and liver. To treat metastases, it is necessary to remove the primary tumor and tissues of the regional lymph nodes. After this, the patient undergoes a course of chemotherapy and radiation. If the metastases reach large sizes, they are removed surgically.

Diagnosis of sarcoma

Sarcoma diagnostics are extremely important, as they help to establish the location of the malignant neoplasm, the presence of metastases, and sometimes the causes of the tumor. Sarcoma diagnostics 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, consistency. Also, the doctor must examine the regional lymph nodes for metastases. In addition to visual examination, the following are used to diagnose sarcoma:

• Computer and magnetic resonance imaging – these methods provide important information about the size of the tumor and its relationships with other organs, nerves and main vessels. Such diagnostics are performed for tumors of the small pelvis and extremities, as well as sarcomas located in the sternum and abdominal cavity.
• Ultrasound examination.
• Radiography.
• Neurovascular examination.
• Radionuclide diagnostics.
• Biopsy – taking sarcoma tissue for histological and cytological examination.
• Morphological examination – is performed to determine the stage of sarcoma, to choose treatment tactics. Allows to predict the course of the disease.

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Sarcoma on ultrasound

Sarcoma on ultrasound is a diagnostic method that allows you to visually see the size of the tumor, the presence of metastases and other features. Ultrasound examination makes it possible to make a presumptive diagnosis. This is due to the fact that in certain cases (early stages, some types of sarcomas and localization sites) the neoplasm is not visible on ultrasound. Ultrasound is not performed to diagnose sarcoma of hollow organs. But such a study makes it possible to determine the tumor by secondary signs (enlarged lymph nodes, secondary metastases).

That is, ultrasound examination is an auxiliary diagnostic method. Sarcoma on ultrasound looks different in different organs and at different stages of development. For example, kidney sarcoma looks like a small nodule, and pancreatic sarcoma has uneven contours, and the lobes of the organ are slightly enlarged, lung sarcoma looks like a small coin.

Prevention of sarcoma

Prevention of sarcoma is carried out in two directions: prevention of the development of malignant neoplasms and prevention of metastasis and relapses of the disease. The first rule of sarcoma prevention is the fight against premature exhaustion of the body and aging. To do this, you need to eat right, lead an active lifestyle, avoid stress and rest.

One should not forget about timely treatment of specific inflammatory diseases that can become chronic (syphilis, tuberculosis). Hygienic measures are a guarantee of normal functioning of individual organs and systems. Treatment of benign tumors that can degenerate into sarcomas is mandatory. As well as warts, ulcers, seals in the mammary gland, tumors and ulcers of the stomach, erosions and cracks in the cervix.

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

Prognosis of sarcoma

The prognosis of sarcoma depends on the localization of the neoplasm, the origin of the tumor, the growth rate, the presence of metastases, the volume of the tumor and the general condition of the patient. The disease is distinguished by the 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 early stages, the disease can be cured without detrimental consequences for the body, but the last stages of malignant tumors have a poor prognosis for the patient's life.

Although sarcomas are not the most common cancers that can be treated, sarcomas tend to metastasize, affecting vital organs and systems. In addition, sarcomas can recur, affecting the weakened body again and again.

Survival in sarcoma

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

Sarcoma is a malignant tumor, which is rightfully considered the cancer of the young. Everyone, both children and adults, is susceptible to the disease. The danger of the disease is that at first, the symptoms of sarcoma are insignificant and the patient may not even know that he has a progressing malignant tumor. 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.