Sarcomas and Soft Tissues Tumors

in #fundition6 years ago

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Sarcomas ... Soft Tissue Tumors

Sarcomas are a group of cancers that have their origin in connective tissue cells, also known as connective or supportive. This tissue forms the structure of the human body and its organs and can adopt different qualities, depending on the type of cells that form it: fat, muscle, blood vessels, cartilage, tendons and bones, among others.

Sarcomas are mainly divided into bone sarcomas, the most common being osteosarcoma, and soft tissue sarcomas.

As explained by the Spanish Society of Medical Oncology (SEOM), soft-tissue sarcomas are malignant tumors located in the soft tissues, that is, they exclude bone and cartilage, and include fatty tissue, muscle, tendons, blood vessels, nerves and deep tissues of the skin.

These rare tumors can occur anywhere in the body. However, they are more common in the legs and arms. They can also appear on the trunk, head, back of the abdominal cavity, and internal organs.

Although there are more than 50 subtypes of sarcomas, they are grouped as SPB because many have common characteristics.

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Causes

As with other types of cancer, such as osteosarcoma or brain tumors, the causes of soft tissue sarcomas are unknown.

In addition, most cases that have been diagnosed are not associated with any known risk factors. Even so, in some tumors there are predominant risk factors:

Presence of hereditary rare diseases: Especially neurofibromatosis and Von Recklinghausen disease, which are linked to some types of sarcomas.

Patients who have received radiation therapy years ago are at greater risk of developing sarcomas. In these cases the cancer is very resistant to treatment.

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Diagnosis

When specialists suspect soft tissue sarcoma, the first test to diagnose it is a magnetic resonance imaging (MRI) scan of the area. This test will confirm whether the patient has a tumour and provide information such as the characteristics of the tumour or whether it has affected nearby organs, for example. In this way, doctors can plan the surgery well.

If the results of the MRI show that there is a tumour, the definitive test to confirm this is the biopsy. Oncologists warn that it is essential that a biopsy is always performed before the tumour is removed, as surgical intervention changes if the tumour is benign or malignant.

If the biopsy confirms that it is a malignant tumour, the specialists will have to carry out a thoracic CT to rule out metastasis in the lung.

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Treatments

Because this is a disease with a low incidence (see Other data), heterogeneity and therapeutic complexity, experts recommend that patients receive treatment in multidisciplinary centers.

Localized Sarcoma

When the soft tissue sarcoma does not have metastases the therapeutic options are:

Surgery:
It is the main option. The specialist must be able to remove the tumor with healthy tissue around it to ensure margins of resection free of tumor cells.

This can be obtained by ample surgery (with tumor-free margins) or radical surgery (either by amputating the limb and compartment surgery or by resecting the entire muscle compartment). The broad one is less mutilating than the radical one and obtains the same results without reducing the chances of cure. However, in some areas, extensive surgery cannot be performed.

Radiotherapy:
The patient receives ionizing radiation in addition to surgery to remove the microscopic remains of the tumor and prevent it from reappearing.

Adjuvant chemotherapy:
Specialists recommend this treatment after surgery to decrease the risk of the tumor leading to metastasis. Its administration is only justified in sarcoma of soft parts of high grade and size that are located in the extremities. If the tumor is of a lesser grade or is located elsewhere in the body, chemotherapy is not effective.

SEOM points out that in recent years two complementary techniques have been incorporated to treat soft tissue sarcomas: postoperative radiotherapy and reconstructive plastic surgery techniques. These have considerably reduced the number of amputations without compromising healing.

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If you need recommendations or help in orthopedic surgery and traumatology do not hesitate to contact me.

Dr. Leopoldo Maizo - Orthopedic Surgeon

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