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Adult soft tissue sarcoma

Definition

Soft tissue sarcoma (STS) is cancer that forms in the soft tissue of the body. Soft tissue connects, supports, or surrounds other body parts. In adults, STS is rare.

There are many different types of soft tissue cancers. The type of sarcoma depends on the tissue it forms in:

  • Muscles
  • Tendons
  • Fat
  • Blood vessels
  • Lymph vessels
  • Nerves
  • Tissues in and around joints

The cancer can form almost anywhere, but is most common in the:

  • Head
  • Neck
  • Arms
  • Legs
  • Trunk
  • Abdomen

Alternative Names

STS; Leiomyosarcoma; Hemangiosarcoma; Kaposi's sarcoma; Lymphangiosarcoma; Synovial sarcoma; Neurofibrosarcoma; Liposarcoma; Fibrosarcoma; Malignant fibrous histiocytoma; Dermatofibrosarcoma; Angiosarcoma

Causes

It is not known what causes most sarcomas. But there are certain risk factors:

  • Some inherited diseases, such as Li-Fraumeni syndrome
  • Radiation therapy for other cancers
  • Exposure to certain chemicals, such as vinyl chloride or certain herbicides
  • Having swelling in the arms or legs for a long time (lymphedema)

Symptoms

In early stages, there are often no symptoms. As the cancer grows, it may cause a lump or swelling that keeps growing over time. Most lumps are NOT cancer.

Other symptoms include:

  • Pain, if it presses on a nerve, organ, blood vessel, or muscle
  • Blockage or bleeding in the stomach or intestines
  • Breathing problems

Exams and Tests

Your health care provider will ask you about your medical history and do a physical exam. Other tests may include:

If your provider suspects cancer, you might have a biopsy to check for cancer. In a biopsy, your provider collects a tissue sample to examine in the lab.

The biopsy will show if cancer is present and help show how quickly it is growing. Your provider may ask for more tests to stage the cancer. Staging can tell how much cancer is present and whether it has spread.

Treatment

All types of STS's in adults are treated the same way.

Surgery is the most common treatment.

  • In early stages, the tumor and some healthy tissue around it is removed.
  • Sometimes, just a small amount of tissue needs to be removed. Other times, a wider area of tissue must be removed.
  • With advanced cancers that form in an arm or leg, surgery may be followed by radiation or chemotherapy. Rarely, the limb may need to be amputated.

You also may have radiation or chemotherapy:

  • Used before surgery to help shrink the tumor to make it easier to remove the cancer
  • Used after surgery to kill any remaining cancer cells

Chemotherapy may be used to help kill cancer that has metastasized. This means it has spread to different areas of the body.

Two newer therapies being evaluated are:

  • Infusing the chemotherapy only in the limb (arm or leg) where the cancer is found.
  • Regional hyperthermia

Support Groups

Cancer affects how you feel about yourself and your life. You can ease the stress of illness by joining a cancer support group. Sharing with others who have had the same experiences and problems can help you feel less alone.

Ask your provider to help you find a support group for people who have been diagnosed with STS.

Outlook (Prognosis)

The outlook for people whose cancer is treated early is very good. Most people who survive 5 years can expect to be cancer-free at 10 years.

Possible Complications

Complications include side effects from surgery, chemotherapy, or radiation.

When to Contact a Medical Professional

See your provider about any lump that grows in size or is painful.

Prevention

The cause of most STSs isn't known and there is no way to prevent it. Knowing your risk factors and telling your provider when you first notice symptoms can increase your chance of surviving this type of cancer.

References

Contreras CM, Heslin MJ. Soft tissue sarcoma. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 31.

Helman LJ, Maki RG. Sarcomas of soft tissue. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff's Clinical Oncology. 5th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 93.

National Cancer Institute. PDQ: adult soft tissue sarcoma treatment - health professional version. Cancer.gov Web site. Updated January 29, 2016. www.cancer.gov/types/soft-tissue-sarcoma/hp/adult-soft-tissue-treatment-pdq#section/all. Accessed October 17, 2016.

Review Date:8/15/2016
Reviewed By:Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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