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Soft Tissue Sarcoma
Also known as Liposarcoma, fibrosarcoma, malignant fibrous histiosarcoma, and synovial sarcoma
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A sarcoma is a is a specialized form of connective tissue cancer that involves cancer of the blood vessels, nerves, bones, cartilage, muscle and fat. Non-bone sarcomas are rare and can occur just about anywhere in the body, including the trunk or the extremities. The chest, pelvis and abdomen are common places for sarcomas to occur. Regardless of the type of sarcoma or its location, the treatment is roughly the same for each type of cancer.
A liposarcoma is also called an atypical lipoma or an atypical lipomatous tumor. It arises within fat cells within the deep tissues of the body and is commonly occurring in the deep part of the thigh or deep within the back I the retroperitoneum. Such tumors are often large and bulky, with smaller satellite tumors extending outside of the main body of the cancer. Because the tumors are uncommon, some people choose to have them treated at specialty centers that specialize in the treatment of sarcomas. c
The main symptoms and signs include the findings of a deep mass in the soft tissue. They tend to be painless unless they are large and push on nerves. They can occlude blood vessels and nerves and can cause functional disturbances in the body. If the cancer is retroperitoneal, it presents itself with weight loss, emaciation and moderate to severe abdominal pain. The tumors can compress the kidney, leading to kidney failure or can push on the ureters, leading to blockage of the outflow to a kidney. Bowel obstruction is also a possible outcome of a retroperitoneal tumor.
The diagnosis of liposarcoma or other type of soft tissue sarcoma involves doing a CT scan or MRI scan of the affected area so as to see the tumor growing within the tissues. A transcutaneous or open biopsy can be done to show the exact nature of the sarcoma. The sarcoma can be any one of several types of cancerous sarcomas and can look and act the same until the biopsy is looked at under the microscope.
Treatment is done by orthopedic surgeons, radiation oncologists, vascular surgeons, plastic surgeons, general surgeons, and general surgeons-all who specialize in the treatment of bony and soft tissue tumors. There are more than fifty different types of soft tissue tumors and specialists are necessary to understand the characteristics of each type of tumor. While each tumor is treated with excision of the tumor, the type of radiation and chemotherapy differ with each type of tumor. Chemotherapy is used to reduce the tumor bulk by killing off cancer cells preferentially to normal cells. Targeted radiation is performed to shrink the tumor either before or after excision of the main body of the tumor. Usually a combination of these different types of treatment is done in order to kill off the tumor.
Radiation, as mentioned, can be done before or after surgery. It can be done with external beam radiation to the sarcoma in order to shrink the tumors cells. Intraoperative radiation can be done directly onto the place where the tumor was removed and seeds (called brachytherapy) can be inserted into the tumor area that is radioactive. This involves closely zapping the tumor cells using the radioactive beads left inside the body.
Soft tissue sarcomas occur more commonly in adults and less commonly in children or adolescents. Half of all cases result in a cure of the sarcoma. The ability to cure the cancer depends on the age and health of the patient who has the cancer, the grade and type of sarcoma, the size of the tumor when the tumor is diagnosed, where the tumor is located and whether or not there are metastases of the tumor to other body areas. Sarcomas tend not to metastasize when they are first found but tend to be much larger than other cancers at the time of diagnosis.
Soft tissue sarcomas occur most commonly in middle aged and older persons and liposarcomas are the second most common type of soft tissue cancers. Malignant fibrous histiocytomas are the most common type of soft tissue sarcoma. There are about 2.5 individuals per million in the population. The prognosis for well differentiated liposarcomas is good with about a 90 percent survival rate. Some other soft tissue sarcomas have a five year survival rate as little as 39 percent.