Soft Tissue Sarcoma

Definition

Soft tissue sarcoma is growth of cancer cells in soft tissue. Soft tissue includes muscles, tendons, connective tissue, fat, blood vessels, nerves, and joint tissue. There are many types of soft tissue sarcoma.

Causes

Cancer happens when cells divide without control or order. These cells grow together to form a tumor. They can invade and damage nearby tissues. They can also spread to other parts of the body.

It is not clear what causes changes in the cells. It is likely a combination of genes and environment.

Cancer Growth

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Risk Factors

Soft tissue sarcoma is more common in adults over 55 years old. However, it can occur at any age. Things that may raise the risk are:

• Certain genetic syndromes, such as:
  • Li-Fraumeni syndrome
  • Familial adenomatosis polyposis
  • Retinoblastoma
  • Neurofibromatosis
  • Carney-Stratakis syndrome and Carney triad
• Past radiation to the area
• Weak immune system
• Exposure to certain chemicals such as:
  • Chemicals in herbicides and wood preservatives
  • Chlorophenols
  • Dioxin

Symptoms

In the early stages, a sarcoma is small and does not cause symptoms. Symptoms occur as the tumor grows.

The most common symptom is a lump or swelling. It may or may not be painful. Symptoms vary, depending on the part of the body that is affected. For example, tumors found in the following areas of the body may develop these symptoms:

• Arm, leg, or trunk—uncomfortable swelling in the affected limb
• Chest—cough and breathlessness
• Abdomen—belly pain, vomiting, and problems passing stool
• Uterus—bleeding from the vagina and pain in the pelvis or lower belly

Diagnosis

The doctor will ask about symptoms and past health. A physical exam will be done.

Imaging tests will help locate tumors. They may include:

• X-rays
• CT scan
• MRI scan
• Ultrasound
• PET scan

A biopsy will be done to confirm the diagnosis. This involves taking and testing a sample of tissue.

The exam and test results will be used for staging. This will outline how far and fast the cancer has spread.

Treatment

The goal is to remove the cancer. Treatment depends on the type and stage of the cancer. A combination of treatments may be used.

The most common treatment for soft tissue sarcoma is surgery. Surgery alone may be used for tumors that are small and not too deep. It may involve:

• Mohs micrographic surgery—The tumor is cut from the skin in thin layers.
• Wide local excision—The tumor and some normal tissue around it are removed.
• Limb-sparing surgery—The tumor and some tissue are removed from an arm or a leg. The arm or leg is saved. Tissue or bone that is removed may be replaced with tissue grafts. The tissue used for grafts comes from another part of the person's body. Artificial bone may also be used.
• Amputation—Removing part or all of an arm or leg. This is rare.
• Lymphadenectomy—Lymph nodes are removed and checked for cancer.

Radiation therapy may be given before or after surgery to remove the tumor. It may be external or internal radiation therapy.

Chemotherapy may also be used before or after surgery. It may be given by mouth, injection, or IV to kill cancer cells.

Other therapies may be used, such as:

• Targeted therapy—drugs that attack specific cancer cells
• Immunotherapy—drugs that boost the immune system to fight cancer

Medicines may also be given to help manage side effects from the cancer treatments.

Prevention

There are no current guidelines for preventing soft tissue sarcoma.