Is Soft Tissue Sarcoma?
Sarcoma is a type of cancer that develops in bones or soft tissues.
Your soft tissue includes:
- blood vessels
- fibrous tissue
- the lower layers of the skin (not the outer
- the lining of the joints
Several types of abnormal growths can occur in soft tissue. If a
growth is a sarcoma, then it’s a malignant tumor or cancer. Malignant means
that parts of the tumor can break off and spread into surrounding tissues.
These escaped cells move throughout the body and lodge in the liver, lungs,
brain, or other important organs.
Sarcomas of soft tissue are relatively uncommon, especially when
compared with carcinomas, another type of malignant tumor. Sarcomas can be life-threatening,
especially if they’re diagnosed when a tumor is already large or has spread to
There are many kinds of soft tissue sarcomas. A sarcoma is categorized
by the tissue in which it has grown:
- Malignant tumors in fat are called liposarcomas.
- In smooth muscle around internal organs, cancerous
sarcomas are known as leiomyosarcomas.
- Rhabdomyosarcomas are
malignant tumors in skeletal muscle. Skeletal muscle is located the arms, legs,
and muscle that allows movement. Although they also occur in adults,
rhabdomyosarcomas are the most common soft tissue sarcomas in children and
Other soft tissue sarcomas that are very rare include:
- malignant schwannomas
- neurogenic sarcomas
- gastrointestinal stromal tumors
- synovial sarcomas
- Kaposi’s sarcomas
- malignant mesenchymomas
- alveolar soft-part sarcomas
- epithelioid sarcomas
- clear cell sarcomas
- pleomorphic undifferentiated sarcomas
- spindle cell tumors
Are the Symptoms of a Soft Tissue Sarcoma?
A painless lump or mass under the skin of your arm or leg may be
the first sign of a soft tissue sarcoma. If a soft tissue sarcoma develops in your
stomach, it may not be discovered until it’s very large and pressing on other
structures. You may have pain or breathing difficulties from a tumor pushing on
Another possible symptom is an intestinal blockage. This can
occur if a soft tissue tumor is growing in your stomach. The tumor pushes too
hard against your intestines and prevents food from moving through easily.
The most common types of soft tissue sarcomas are
gastrointestinal stromal tumors (GIST) and tumors that affect the limbs. The
majority of soft tissue sarcomas occur in one of the following:
These will show up as a lump under the skin. Some soft tissue
sarcomas affect the stomach or chest and will press against the intestines or
the lungs. These tumors can also appear in the head and neck.
See your doctor if you feel a lump under your skin that doesn’t
go away, grows, or is painful to the touch.
Causes Soft Tissue Sarcomas?
Usually, the cause of a soft tissue sarcoma isn’t identified. The
exception to this is Kaposi’s sarcoma. Kaposi’s sarcoma is a cancer of the
lining of blood or lymph vessels. This cancer causes purple or brown lesions on
the skin. It’s due to infection with the human herpes virus 8 (HHV-8). It frequently
occurs in people with reduced immune function, such as those infected with HIV,
but it can also arise without HIV infection.
Is at Risk for Developing a Soft Tissue Sarcoma?
Genetic Risk Factors
Some genetic defects can make you more prone to developing a soft
- Basal cell nevus syndrome increases your risk of
basal cell skin cancer, rhabdomyosarcoma, and fibrosarcoma.
- Inherited retinoblastoma causes a kind of
childhood eye cancer, but it can also increase the risk of other soft tissue
- Li-Fraumeni syndrome increases the risk of many
kinds of cancer, often from radiation exposure.
- Gardner’s syndrome leads to cancers in the
stomach or bowel.
- Neurofibromatosis can cause nerve sheath tumors.
- Tuberous sclerosis can result in
- Werner’s syndrome can cause many health
problems, including an increased risk of all soft tissue sarcomas.
Exposure to certain toxins, such as dioxin, vinyl chloride, and
herbicides that contain phenoxyacetic acid may increase your risk of developing
soft tissue sarcomas.
Radiation exposure, especially the intense radiation of radiation
therapy, can be a risk factor. Radiation therapy often treats more common
cancers such as breast cancer, prostate cancer, or lymphomas. Unfortunately,
this effective therapy can increase your risk of developing certain other forms
of cancer, such as a soft tissue sarcoma. Patients who received radiation
therapy in the past should be checked for the development of new soft tissue
Is Soft Tissue Sarcoma Diagnosed?
Doctors can usually only diagnose soft tissue sarcoma when the
tumor becomes fairly large because there are very few early symptoms. By the
time the cancer causes recognizable signs, it may already have spread to other
tissues and organs in the body.
If your doctor suspects a soft tissue sarcoma, they’ll get a
complete family history to
see if other members of your family may have had any rare forms of cancer. You
will also likely have a physical exam to check your general health. This may help
determine the treatments that would be best for you.
Your doctor will study the tumor’s location using imaging scans
such as simple X-rays or
a CT scan. The CT scan may
also involve using an injected dye to make the tumor easier to see. Your doctor may also order an MRI.
Ultimately, a biopsy must confirm the diagnosis. A biopsy usually
involves inserting a needle into the tumor and removing a small sample.
Sometimes, your doctor will use a scalpel to cut away part of the tumor so that
it’s easier to examine. Other times, especially if the tumor is pressing on an
important organ such as the intestines or the lungs, your doctor will remove the
entire tumor and surrounding lymph nodes before performing a biopsy.
The tissue from the tumor will be examined under a microscope to
determine whether the tumor is benign or malignant. A benign tumor doesn’t
invade other tissue, and a malignant tumor can invade other tissue.
Some other tests performed on a tumor sample from a biopsy include:
- immunohistochemistry, which looks for antigens
or sites on tumor cells to which certain antibodies can attach
- cytogenic analysis, which looks for changes in
the chromosomes of the tumor cells
- fluorescence in situ hybridization (FISH), a
test to look for certain genes or short pieces of DNA
- flow cytometry, which is a test that looks at
the number of cells, their health, and the presence of tumor markers on the
surface of cells
Staging the Cancer
If your biopsy confirms cancer, your doctor will grade and stage
the cancer by looking at the cells under the microscope and comparing them to
normal cells of that kind of tissue. The following are the different stages:
- Stage 1 tumors are small and in a favorable
location, such as the head and neck region.
- Stage 2 tumors are generally between 1 to 5
centimeters and in an unfavorable location, such as the bladder or prostate.
- Stage 3 tumors are either larger than 5
centimeters or have already spread to nearby lymph nodes.
- Stage 4 tumors are at an advanced tumor stage and
have already spread to other distant organs.
Are the Treatments for a Soft Tissue Sarcoma?
Soft tissue sarcomas are rare, and it’s best to seek treatment at
a facility that’s familiar with your type of cancer.
Treatment depends on the location of the tumor and the exact cell
type that the tumor originated from (e.g., muscle, nerve, or fat). If the tumor
has metastasized, or spread to other tissues, this also affects treatment.
Surgical treatment is the most common initial therapy. Your doctor
will remove the tumor and some of the surrounding healthy tissue and test to
see if some tumor cells may still be left in your body. If the tumor is in
other known sites, your doctor can also remove those secondary tumors. Your doctor
may also need to remove surrounding lymph nodes, which are small organs of the
immune system. Lymph nodes are often the first places where tumor cells spread.
In the past, doctors would often need to amputate a limb that had
tumors. Now, the use of advanced surgical techniques, radiation, and
chemotherapy can often save a limb. However, large tumors that affect major
blood vessels and nerves may still require limb amputation.
The risks of surgery include:
- an infection
- damage to nearby nerves
- reactions to anesthetic
Chemotherapy is also used to treat some soft tissue sarcomas.
Chemotherapy is the use of toxic drugs to kill cells that divide and multiply
rapidly, such as tumor cells. Chemotherapy also damages other cells that divide
rapidly, such as bone marrow cells, the lining of your intestine, or hair
follicles. This damage leads to many side effects. However, if cancer cells
spread beyond the original tumor, chemotherapy may effectively kill them off
before they begin to form new tumors and harm vital organs.
Chemotherapy doesn’t kill off all soft tissue sarcomas. However,
chemotherapy regimens do effectively treat one of the most common sarcomas,
rhabdomyosarcoma. Drugs such as doxorubicin and dactinomycin can also treat
soft tissue sarcomas. There are many other drugs that are specific to the
tissue type in which the tumor started.
In radiation therapy, high-energy beams of particles such as
X-rays or gamma rays damage the DNA of cells. Rapidly dividing cells such as
tumor cells are much more likely to die from this exposure than normal cells,
though some normal cells will die as well. Sometimes, doctors combine chemotherapy
and radiation therapy to make each more effective and kill more tumor cells.
The side effects of chemotherapy and radiation include:
- weight loss
- hair loss
- nerve pain
- other side effects that are specific to each
type of drug regimen
Are the Potential Complications of Soft Tissue Sarcoma?
Complications from the tumor itself depend on the location and
size of the tumor. The tumor may press on important structures such as the:
- blood vessels
The tumor may actually invade and damage nearby tissues as well.
If the tumor metastasizes, meaning cells break off and end up in other
locations such as the following, new tumors can grow in these organs:
In these locations, tumors can cause extensive and life-threatening
Is the Long-Term Outlook?
Long-term survival from a soft tissue sarcoma depends on the
specific type of sarcoma. Outlook also depends on how advanced the cancer is
when first diagnosed.
Stage 1 cancer will likely be much easier to treat than stage 4 cancer,
with a much higher survival rate. A tumor that’s small, hasn’t spread into
surrounding tissues, and is in an easily accessible location, such as the
forearm, will be easier to treat and remove completely with surgery.
A tumor that’s large, surrounded by many blood vessels (making
surgery difficult), and has metastasized to the liver or lung is much harder to
The chances of recovery depend on:
- the location of the tumor
- the cell type
- the grade and stage of the tumor
- whether or not the tumor can be surgically
- your age
- your health
- whether the tumor is recurrent or new
After initial diagnosis and treatment, you’ll need to see your
doctor often for checkups even if the tumor is in remission, which means it’s
not detectable or not growing. X-rays, CT scans, and MRIs may be necessary to
check if any tumor is still present at its original site or other places in your