Tumors of soft tissues
Soft tissue tumors are all non-epithelial tumors, except for tumors of the reticuloendothelial system. All anatomical formations that are located between the bones of the skeleton and the skin are called soft tissues of a person. These include smooth muscle, synovial tissue, intermuscular fatty layer, subcutaneous fatty tissue, striated muscles.
According to statistics, malignant tumors of soft tissues in the system of general human oncopathologies occupy about 1%. So, per 100,000 population of the Russian Federation, the incidence is on average 2.3% (2007 data). The number of men and women with soft tissue malignant neoplasms is the same. As a rule, there are no age statistics of the disease, but most often soft tissue tumors are diagnosed in people after 25 years. Mostly they are localized on the limbs or on the thigh.
Content:
- Classification of soft tissue tumors
- Causes of soft tissue tumors
- Symptoms of a soft tissue tumor
- Diagnosis of soft tissue tumors
- Soft tissue tumor treatment
Classification of soft tissue tumors
The classification of malignant soft tissue tumors is as follows:
- Liposarcoma is a tumor that affects adipose tissue. It is divided into low and highly differentiated tumors, and also a mixed type of neoplasms is distinguished separately.
- Rhabdomyosarcoma is a tumor that affects muscle tissue. This neoplasm can be spindle cell, giant cell and mixed.
- Leiomyosarcoma is a tumor that affects muscle tissue. Neoplasms can be round-cell or spindle-cell.
- Hemangiosarcoma is a tumor that affects the blood vessels. The neoplasm is divided into Kaposi's sarcoma, hemangiopericytoma and hemangioendothelioma.
- Lymphangiosarcoma is a tumor that affects the lymphatic vessels.
- Fibrosarcoma is a tumor that affects connective tissue. Neoplasms are subdivided into spindle cell and round cell tumors.
- Synovial sarcoma is a tumor that affects the synovial membranes. Neoplasms are round-cell and spindle-cell.
- Nerve tissue sarcomas. Distinguish between neurogenic sarcomas, neurinomas, schwannomas, ganglioneuroblastomas, sympathoblastomas.
- Fibrosarcomas affect the skin and are, like neurinomas, tumors of ectodermal etiology.
Causes of soft tissue tumors
The causes of soft tissue tumors are as follows:
- More than 50% of soft tissue tumors are caused by previous trauma.
- The process of tumor malignancy is often observed, in which a benign neoplasm is transformed into a malignant one.
- The formation of a tumor from scar tissue is possible. Thus, fibrosarcoma is often formed.
- Recklinghausen's disease in some cases causes the formation of neuromas.
- The risk factor is radiation exposure of the body.
- The development of soft tissue tumors against the background of previous bone pathologies is possible.
- Multiple tumors of soft tissues are a manifestation of inherited diseases, such as tuberous sclerosis.
- Genetic mechanisms responsible for the development of soft tissue tumors are not excluded.
- There are suggestions in the medical literature that soft tissue sarcomas can occur after viral infections, but clear evidence of 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 a soft tissue injury.
Symptoms of a soft tissue tumor
Symptoms of soft tissue tumors are often blurred and do not give a vivid clinical picture. Patients go to the doctor, most often, about an independently defined subcutaneous tumor.
Other symptoms of soft tissue tumors can be:
- The tumor remains painless for a long time, does not disrupt the functioning of the limbs and internal organs, does not bother a person in any way. In this regard, there is no appeal for medical help.
- The patient can go to the doctor with a complaint of neuralgia, ischemia or other disorders that arise as a result of the pressure of the tumor on a nerve or on a vessel. It directly depends on its location.
- As the disease progresses, weight loss occurs, and fever may develop. The person begins to suffer from severe weakness, which he cannot explain.
- The skin is disturbed, as a rule, with large tumors. Most often it manifests itself in skin ulceration.
-
The tumors themselves are dense, elastic in consistency, although sometimes soft areas can be detected. If there are any, then most often this indicates the process of disintegration of the neoplasm.
The most striking symptoms of a soft tissue tumor 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 most often located 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 form inside the tumor) and solid (when calcium salts are deposited in the tumor).
- Liposarcoma symptoms. Liposarcoma can occur anywhere in the body where there is adipose tissue. Her favorite place of localization is the thigh. The boundaries of the tumor are blurred, but it is palpable well. This is precisely the leading symptom of a tumor. The growth of the neoplasm is slow, it rarely gives metastases.
- Rhabdomyosarcoma symptoms. The tumor more often affects men over the age of 40. The neoplasm is well felt in the thickness of the muscles and is a dense, immobile node. Pain for this type of tumor is not typical. Its favorite place of localization is the neck, limbs, pelvis and head.
- Fibrosarcoma symptoms. This type of tumor prefers the muscles of the limbs and trunk. It is a lumpy neoplasm with relative mobility. The knot can be oval or round. More often, a tumor is formed in women, reaches a large size, while the skin is rarely ulcerated.
- Leiomyosarcoma symptoms. This tumor is rarely diagnosed, most often it affects the uterus. It manifests itself in the late stages of development and refers to the so-called "silent tumors". A tumor is detected when assisting during uterine bleeding, which is often complicated by suppuration.
- Angiosarcoma symptoms. It is a collective term for malignant tumors of the blood vessels. Tumors most often have a soft consistency, 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 in 50% of cases is accompanied by pain and other disorders of the nervous system. Such neoplasms grow slowly, most often they are 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 with its examination. Without fail, the patient is sent for x-ray of the lesion site and for histological examination of the tumor.
X-rays provide information if there is a solid tumor. In this case, the doctor receives information regarding the interdependence of the tumor with the adjacent bones of the skeleton.
Angiography allows you to determine the blood supply system of the tumor, provides accurate information about its location.
MRI and CT can help clarify the extent 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 collect tumor tissue for further cytological examination. It is this method that makes it possible 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 the 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 soft tissues due to its invasion and metastasis.
Chemotherapy and radiation therapy are used if the type of tumor diagnosed is sensitive to these methods of treatment. So, rhabdomyosarcoma and angiosarcoma respond well to radiation exposure. Neurinomas, fibrosarcomas, and liposarcomas are tumors with low sensitivity to chemotherapy and radiation therapy.
The prognosis for five-year survival depends on the type of tumor, on the patient's age, on the stage of the disease, etc. The most unfavorable prognosis in synovial sarcoma (5-year survival rate does not exceed 40%). The rest of the tumors with a successful operation have a higher survival threshold.
The author of the article: Bykov Evgeny Pavlovich | Oncologist, surgeon
Education: graduated from residency at the Russian Scientific Oncological Center. N. N. Blokhin "and received a diploma in the specialty" Oncologist"
