Facts

In this section you will find answers to the following important questions.

What is sarcoma?

Can sarcoma be discovered early?

How are soft tissue sarcomas diagnosed?

Sarcoma is a general class of uncommon cancers in which the cancer cells arise from or resemble normal cells in the body known as "connective tissues". Normal "connective tissues" include fat, muscle, blood vessels, deep skin tissues, nerves, bones, and cartilage. Cancers of cells which resemble any of these normal tissues are known as "sarcomas". Sarcomas are sub-classified based upon the specific type of cell that makes up the cancer. Some of the most common subtypes of sarcoma are listed below.

	Liposarcomas are malignant tumors which develop from fat tissue. They can develop anywhere in the body, but they most often grow in the retroperitoneum (tissue at the back of the abdominal cavity).
	Leiomyosarcomas are malignant tumors which develop from smooth muscle tissue. (Smooth muscle is the type of muscle over which your brain does not have conscious control like the muscle fibers in the uterus or in the walls of blood vessels.) They can arise anywhere in the body but the uterus or gastrointestinal tract are two relatively common locations for leiomyosarcoma.
	Rhabdomyosarcoma are malignant tumors which resemble developing skeletal muscle. These tumors most commonly grow in the arms or legs, but can also develop in the head or neck area, as well as the urinary and reproductive organs.
	Synovial Sarcoma is a malignant tumor made up of cells which resemble the cells in joints. ("Synovial cells" line the joints.) However, synovial sarcoma does not necessarily arise in any joint, and the name is probably a misnomer, since the cancer cells are probably quite different from normal joint cells. Synovial sarcomas can arise in any location in the body, and it often appears in young adults.
	Angiosarcoma are malignant tumors that resemble blood or lymphatic vessels.
	Fibrosarcoma is cancer of the fibroblast-type cells in the body which form scars and do other important connective functions.
	Malignant Peripheral Nerve Sheath Tumor (MPNST) is a cancer of the cells that surround nerves -- it is also called neurofibrosarcoma.
	Gastrointestinal Stromal Tumor (GIST) also known as GI Stromal Sarcoma is an increasingly recognized diagnosis of connective tissue cancerous cells which support the GI tract.
	Desmoid Tumor is not strictly a sarcoma since it is not technically a malignancy. However, since it has risk of coming back, it is a tumor which generally should be managed by a team skilled in sarcoma management.
	Ewing's Sarcoma is also known as Peripheral Neuroectodermal Tumor (PNET). It is a class of diseases which arise from very primitive cells in the body. Although this is usually thought of as a bone tumor, Ewing Sarcoma is increasingly recognized to arise in soft tissues in the body as well.
	Osteosarcoma (also known as osteogenic sarcoma) is a tumor of cells which form bone.

Chondrosarcoma is a tumor of cells which form cartilage.

CAN SOFT TISSUE SARCOMA BE DISCOVERED EARLY?

If you have a history of more than one family member with sarcoma, you should discuss genetic testing with your physician. There are certain family syndromes which predispose to the development of sarcoma. However, these are very, very rare and the vast majority of patients with sarcoma do not risk passing on any increased risk of developing sarcoma to their children.

As with concerns for any cancer, in general, you should notify your physician if you discover any lumps or growths.

Since the symptoms of sarcoma do not show up until the disease is advanced, you should see your physician if any of the following problems arise:

Any new lump or growing lump appears on your body.

Increasing abdominal pain.

Blood in your stools or vomit (when blood appears in your stool it may not look red but the stool may look black and tarry).

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HOW ARE SOFT TISSUE SARCOMAS DIAGNOSED?

Medical History

Biopsy

Medical History and Physical Examination

A complete medical history is necessary to check for symptoms and risk factors.

A physical examination is necessary to provide the physician with other medical signs and symptoms of sarcoma and other health problems.

Ultrasound which uses sound waves to identify the mass.

Computed tomography (CT scan) which takes pictures like an x-ray from different angles. This provides the physician with a picture of the inside of your body.

Magnetic Resonance Imaging (MRI) this type image is similar to the image produced by the CT, however, the MRI shows blood vessels in greater detail and allows the cross-sectional views to be shown in different directions.

Biopsy

To make the diagnosis of sarcoma, and to specifically place any sarcoma in the particular subtype category, it is critical to evaluate the cancer cells and see what they look like under the microscope. A biopsy is a procedure which removes some tissue form the tumor in order to examine it under the microscope and with other lab tests. A biopsy can be a very useful tool, and it is the only way to be certain that the tumor is sarcoma and not some other type of cancer. In addition, it may reveal non-cancerous disease.

A biopsy is also able to determine the type of sarcoma present, as well as the grade of the disease. The grade of the disease determines the severity ( how rapid the disease will grow and spread to other parts of your body).

Based on the size and location of the tumor, physician will choose a specific type of biopsy to diagnose sarcoma.

OFTEN THE DIAGNOSIS IS A CRITICAL PART OF THE CARE PROCESS. PLANNING HOW TO APPROACH THE DIAGNOSTIC PROCEDURE CAN BE A VITAL PART OF THE CARE OF SARCOMA PATIENTS.

Fine needle aspiration (FNA) biopsy: The advantage of this type of biopsy is that it doesn't require surgery. However, sometimes the FNA technique cannot diagnose sarcoma and its grade with certainty. Due to the thin needle technique, you cannot always remove enough tissue to evaluate the disease.

Core needle biopsy: This type of biopsy removes a much larger piece of tumor as compared to the FNA. This cylindrical piece of tissue allows physicians to see if sarcoma is present, as well as the grade of the tumor.

Excisional or Incisional biopsy: This procedure is performed by a surgeon who makes a cut through the skin to remove the entire mass (excisional biopsy) or a small part of the tumor (incisional biopsy). Depending on the location of the tumor different forms of anesthesia are used for the management of pain.