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soft tissue tumors – These are all non-epithelial tumors, except tumors of the reticuloendothelial system. Human soft tissues are all anatomical formations that are located between the bones of the skeleton and the skin. These include smooth muscles, synovial tissue, intermuscular adipose tissue, subcutaneous adipose tissue, and striated muscles.
According to statistics, malignant tumors of soft tissues in the system of general human oncopathologies occupy about 1%. So, per 100 population of the Russian Federation, the incidence is on average 000% (2,3 data). The number of men and women with malignant neoplasms of soft tissues is the same. As a rule, there is no age statistics of the disease, but most often soft tissue tumors are diagnosed in people after 2007 years of age. Mostly they are localized on the limbs, or on the thigh.
Classification of soft tissue tumors
The classification of malignant soft tissue tumors is as follows:
Liposarcoma – a tumor that affects adipose tissue. It is subdivided into low- and highly differentiated tumors, and a mixed type of neoplasms is also isolated separately.
Rhabdomyosarcoma – a tumor that affects muscle tissue. This neoplasm can be spindle cell, giant cell and mixed.
Leiomyosarcoma – a tumor that affects muscle tissue. Neoplasms can be round cell or spindle cell.
Hemangiosarcoma – a tumor that affects the blood vessels. The neoplasm is subdivided into Kaposi’s sarcoma, hemangiopericytoma and hemangioendothelioma.
Lymphangiosarcoma – a tumor that affects the lymphatic vessels.
Fibrosarcoma – a tumor that affects the connective tissue. Neoplasms are divided into spindle cell and round cell tumors.
synovial sarcoma – a tumor that affects the synovial membranes. Neoplasms are round cell and spindle cell.
Sarcomas from nervous tissue. There are neurogenic sarcomas, neurinomas, schwannomas, ganglioneuroblastomas, sympathoblastomas.
Fibrosarcomas affect the skin and, like neuromas, belong to tumors of ectodermal etiology.
Causes of soft tissue tumors
The causes of soft tissue tumors are as follows:
The causes of soft tissue tumors in more than 50% are due to previous trauma.
Often there is a process of malignancy of the tumor, in which a benign neoplasm is transformed into a malignant one.
Perhaps the formation of a tumor from scar tissue. Thus, fibrosarcoma is often formed.
Recklinghausen’s disease in some cases causes the formation of neurinomas.
The risk factor is radiation exposure of the body.
It is possible to develop soft tissue tumors against the background of previous bone pathologies.
Multiple soft tissue tumors are a manifestation of inherited diseases, such as tuberous sclerosis.
Genetic mechanisms that cause the development of soft tissue tumors are not excluded.
There are suggestions in the medical literature that soft tissue sarcomas may occur after viral infections, but clear evidence for this theory has not yet been provided.
In general, little is known about the causes of soft tissue tumors. The generally accepted thesis is only that most often a malignant neoplasm is preceded by soft tissue injury.
Symptoms of a soft tissue tumor
Symptoms of soft tissue tumors are most often blurred and do not give a vivid clinical picture. Patients go to the doctor, most often, about a self-defined subcutaneous tumor.
Other symptoms of soft tissue tumors may include:
The tumor remains painless for a long time, does not disturb the functioning of the limbs and internal organs, and does not bother a person in any way. As a result, no medical attention is sought.
The patient may go to the doctor with a complaint of neuralgia, ischemia, or other disorders that occur as a result of tumor pressure on a nerve or vessel. It directly depends on its location.
As the disease progresses, weight loss occurs and fever may develop. A person begins to suffer from a strong weakness that he is not able to explain.
Skin integuments are broken, as a rule, at tumors of the big sizes. Most often this manifests itself in ulceration of the skin.
The tumors themselves are dense and elastic in consistency, although sometimes it is possible to detect soft areas. If there are any, then most often this indicates the process of disintegration of the neoplasm.
The most striking symptoms of soft tissue tumors of various types should be considered separately:
Symptoms of synovial sarcoma. The most commonly diagnosed soft tissue tumor is synovial sarcoma, which affects people of all ages. It is located most often near the joints or bones of the arms and legs, and is manifested by painful sensations. Its consistency can be varied – elastic (when cystic cavities are formed inside the tumor) and solid (when calcium salts are deposited in the tumor).
Symptoms of liposarcoma. Liposarcoma can occur anywhere on the body where there is fatty tissue. Her favorite place of localization is the thigh. The borders of the tumor are blurred, but it is palpated well. This is what is the leading symptom of the tumor. The growth of the neoplasm is slow, it rarely gives metastases.
Symptoms of rhabdomyosarcoma. The tumor often affects men over the age of 40. The neoplasm is well palpable in the thickness of the muscles and is a dense fixed knot. Pain is not typical for this type of tumor. A favorite place for its localization is the neck, limbs, pelvis and head.
Fibrosarcoma symptoms. This type of tumor prefers the muscles of the limbs and torso. It is a tuberous neoplasm with relative mobility. The node may be oval or round. More often, a tumor is formed in women, it reaches a large size, while the skin rarely ulcerates.
Symptoms of leiomyosarcoma. This tumor is diagnosed quite rarely, most often affects the uterus. It manifests itself in the later stages of development and refers to the so-called “silent tumors”. A tumor is found when assisting during uterine bleeding, which is often complicated by suppuration.
Angiosarcoma symptoms. This is a collective term for malignant tumors of the blood vessels. Tumors most often have a soft texture, do not hurt when pressed on them. Such neoplasms are located in the deep layers of soft tissues.
Symptoms of a neuroma. Since neuromas affect nerve fibers, the process of their formation and development is accompanied by pain and other disorders of the nervous system in 50% of cases. Such neoplasms grow slowly, most often located on the thighs and on the lower leg.
Other malignant tumors develop very rarely, and their main symptom is the appearance of a palpable subcutaneous neoplasm.
Diagnosis of soft tissue tumors
Diagnosis of a soft tissue tumor begins with palpation of the formation and its examination. Without fail, the patient is sent for an x-ray of the site of the lesion and for a histological examination of the tumor.
X-ray provides information in the presence of a solid tumor. In this case, the doctor receives information regarding the interdependence of the tumor with adjacent bones of the skeleton.
Performing angiography allows you to determine the blood supply system of the tumor, gives accurate information about its location.
MRI and CT can clarify the degree of prevalence of the oncological process. These two types of instrumental diagnostics are informative in terms of obtaining information about neoplasms located on the trunk and when they grow deep into other organs.
An aspiration biopsy is performed to take tumor tissue for further cytological examination. It is this method that allows us to judge the nature of the oncological process.
Soft tissue tumor treatment
Treatment of soft tissue tumors is based on three methods – surgery, radiation therapy and chemotherapy. Often these methods are combined to achieve the best effect. The priority remains the surgical removal of a malignant neoplasm.
Since almost all soft tissue tumors are prone to recurrence, the operation is most often performed radical with the most complete excision of the tissues surrounding the tumor. Amputations and exarticulations are performed if the neoplasm cannot be excised from the soft tissues due to its germination and metastasis.
Chemotherapy and radiation therapy are used if the diagnosed type of tumor is sensitive to these methods of treatment. Thus, rhabdomyosarcoma and angiosarcoma respond well to radiation exposure. Neurinomas, fibrosarcomas and liposarcomas are tumors with low sensitivity to chemotherapy and radiotherapy.
The prognosis for a five-year survival rate depends on the type of tumor, on the age of the patient, on the stage of the disease, etc. The most unfavorable prognosis for synovial sarcoma (5-year survival rate does not exceed 40%). Other tumors with a successful operation have a higher survival threshold.