Cancer of muscle tissue in medicine is called myosarcoma, and connective - sarcoma. Similar cellular structures in the human body are almost everywhere, due to which the tumor process can start in a variety of organs. On average, among oncological pathologies in adults in our country, this option accounts for 0.7% of cases. For children, the figures are significantly higher - up to 6.5%, which makes the disease the fifth cancer in terms of frequency of occurrence. A distinctive feature is rapid aggressive growth and a tendency to quickly metastasize. In addition, such cancers have an increased risk of recurrence, even if a successful operation has already been performed. This is especially true for juvenile patients.
What provokes?
Soft tissue cancer in children and adults can occur for a variety of reasons. So far, several risk factors have been identified, but a complete list of initiating disastersfailed to formulate. It has been established that ionizing rays, as well as ultraviolet, can have a strong influence. Sarcoma has been found to be more common among those who have previously undergone radiation or chemical treatment.
You are more likely to find out for yourself what cancer of the soft tissues of the leg, torso, and other parts of the body is, if, due to work, a person is forced to regularly come into contact with carcinogens. Similar results can be caused by malfunctioning of the immune system, HIV and genetic factors. It has been established that if there are persons with sarcoma among blood relatives, a person faces an increased risk of developing the disease. In addition, among the patients there are people who have previously had lymph nodes removed, as well as those who previously suffered from benign neoplasms.
Types and forms
In modern medicine, a classification system for soft tissue cancer has been introduced. If other varieties of malignant diseases are localized in a particular organ, then sarcoma is distinguished by the unpredictability of the location. On average, approximately half of all cases occur in the limbs, up to 40% of patients suffer from cancerous processes in different parts of the body. In every tenth case, sarcoma is detected on the head and neck. Much less often, the pathology is localized in the stomach or intestinal tract.
Among other varieties, angiosarcomas are distinguished, formed by cellular vascular structures of the lymphatic and circulatory systems. Embryonic cells can become the basis for the development of mesenchymoma. From fat cells can begin to growliposarcoma, and from the striated muscles of the skeleton - rhabdomyosarcoma. Finally, leiomyosarcoma initiates in smooth muscle fibers. Such a neoplasm is formed in various internal organs. Among other areas of localization, the most common are: uterus, intestine, stomach. Fibrous tissue may be the basis for the development of histiocytoma, starting from ligamentous tissue and tendons.
In total, modern doctors know about fifty varieties of soft tissue cancer. Among adult patients, approximately 40% of cases are histiocytoma, liposarcoma. Malignant processes in skeletal muscles are much more common in children.
Step by step
The development of the pathological process in the study is assessed not only by the area of localization (for example, striated muscles), but also by the level of progress of the condition. Determining the stage is possible after clarifying the dimensions of the neoplasm, identifying metastases located nearby and in remote parts of the body. Possible damage to the lymphatic system in the periphery. In addition, it is necessary to accurately determine the level of malignancy of the process. In many ways, it follows from the stage how the disease should be treated.
Exploring the case of soft tissue cancer of the neck, trunk, limbs, in clinical conditions, the dimensions of the primary focus are determined. To do this, you need to do an ultrasound examination, X-ray, MRI, CT. To assess malignancy, tissue samples are taken during a biopsy, which are then analyzed under a microscope. The level of damage to the lymphatic system and the presencewidespread metastasis is quite difficult to determine, you have to turn to numerous methods and methods for analyzing the state. Specific ones are chosen based on the nuances of the location of the primary focus, the patient's condition and the characteristics of the course of the process.
WHO, UICC, AJCC: on categorization
Currently, the investigation and categorization of all soft tissue cancers of the thigh, trunk, head and other areas of localization is based on the system adopted in 2011, recommended for use at the world level. 1A - designation of a low level of malignancy. This category includes processes whose dimensions are less than 5 cm, the lymphatic system is normal. 1B - also a low-grade process without violation of the lymphatic structure, but the size of the focus exceeds 5 cm.
Stage 2A soft tissue cancer - a condition in which the level of malignancy is average, the dimensions do not exceed 5 cm, the lymphatic system is normal, distant metastases cannot be detected. Similar process parameters, but a high level of malignancy, allow us to rank sarcoma in group 3A. 3B - a class that is characterized by a high level of malignancy, but the lymphatic system is normal, the process has not spread to distant parts of the organ, while the neoplasm is more than 5 cm in size.
Finally, stage 4 soft tissue cancer is an oncological disease complicated by damage to the lymphatic system. Studies allow you to identify distant metastases. One or both of these signs is possible. The dimensions of the tumor and the level of its malignancy do not play a role in determining whether a case belongs to the fourth stage.
How is it going?
Determination of signs of soft tissue cancer due to information about the processes occurring as the pathology progresses. It has been established that the influence of aggressive factors leads to cell mutation and uncontrolled reproduction of structures. The focus gradually increases, covering the tissues located nearby and initiating destructive processes in them. It is clear from the studies carried out that in many cases a pseudocapsule is formed. It is not a limit to the spread of the tumor, typical cells extend beyond that area. There may be several foci of growth. This, in particular, is inherent in rhabdomyosarcoma.
Soft tissue cancer spreads through the bloodstream, metastases predominantly travel hematogenously. Most often, the localization area is the respiratory system. Approximately 1-2 patients out of every ten patients are affected by nearby lymph nodes.
Features of the disease
Doctors, examining sarcomas, identifying their features, formulating what they are (uterine leiomyomas, rhabdomyo-, lipo-, angiosarcomas and other types), have established that in an impressive percentage of cases, successful surgery does not mean a complete recovery of a person: The process tends to restart.
Symptomatics
The first symptom of soft tissue cancer is the formation of a tumor. At first, the disease does not bother with painsyndrome, but gradually the neoplasm becomes larger. In many cases, studies reveal a pseudocapsule. It is often possible to associate a previous injury with a tumor process. In some cases, pain is a concern. It depends on the area of localization of the neoplasm and its dimensions. As observations have shown, various malignant formations are formed in different patients. In some they are round, in others they resemble a spindle. Infiltrative growth gives fuzzy boundaries.
Feeling the affected area allows you to feel the density and elasticity of the area. If the process has progressed significantly, softening of the structures is possible, indicating tissue decay. If the dimensions of the focus are large, ulceration zones may appear on the skin above the tumor. In the predominant percentage of cases, the site is immobile or has little mobility, there is a connection with the skeletal system. Possible impairment of the functionality of the limbs (depending on location).
Pay attention
Sometimes the symptomatology makes it possible to understand that the pathology of the internal organs is developing - for example, uterine leiomyoma. What is it, the doctor will tell after making an accurate diagnosis. Malignant processes localized in the connective tissues of various organs, the space behind the peritoneum, can provoke non-standard symptoms of the process. Much is determined by the localization and dimensions of the pathology, the ability of atypical structures to spread to nearby he althy ones.
Uterine leiomyosarcoma, in particular, often initiates bleeding. Women suffering from cancer note the pain and duration of the menstrual cycle. If the intestinal tract is affected, the first manifestation of the pathology may be organ obstruction - at first partial, gradually progressing to absolute.
According to statistics, up to 87% of patients go to the clinic when the process has gone far. The best prognosis, of course, is for those who start treatment for soft tissue cancer in a timely manner. To minimize the risk, with suspicious symptoms, you should immediately undergo a full examination, excluding or capable of confirming oncological processes.
Special case: Ewing's sarcoma
What kind of disease is this, any oncologist can tell: the term denotes oncological processes occurring in the bone skeleton. The most common area of localization is the limbs. Possible malignant foci in the clavicles, spine, pelvic skeletal region. The disease was first identified in 1921 by the scientist Ewing, after whom the pathology is now called. Currently, among all malignant processes, it is she who is considered one of the most aggressive.
The presence of metastases can be detected in almost half of the patients whose visit to the clinic allowed us to detect Ewing's sarcoma in them. What kind of disease this is, children over the age of five often recognize by themselves. Very rarely, the pathology occurs in people older than 30 years. The greatest risks are in the age group of 10-15 years. The disease is more common in boys. big riskwhite children are affected among all races.
Clarification of the diagnosis
If you suspect sarcoma, you need to get an appointment at a specialized clinic as soon as possible. When a tumor process is detected, the patient is sent for tests to clarify the dimensions and location of the focus. To do this, you need to do an ultrasound, CT scan, MRI, X-ray. The maximum useful information, as it is believed, can be obtained during an MRI. In some cases, angiography is indicated, which allows to clarify the features of the blood supply to the area, as well as the connection with the vascular system.
When diagnosing, one cannot do without a biopsy of the area. This helps to identify atypical cellular features of the area and the level of malignancy of the process. Evaluating the results of the biopsy, the case is considered at a certain stage, and a therapeutic course is developed. The most useful biopsy will be if doctors have enough materials for research. As a rule, an electron microscopy technique is needed.
How to treat?
If possible, the patient is prescribed a radical surgical intervention, during which both the tumor focus and nearby tissue structures are removed from the body. A resection is possible, during which the tumor is removed. After surgical measures, a course of irradiation is indicated. Perhaps the appointment of a comprehensive program, including chemicals. Sometimes radiation is done before surgery.
It is noted that wide resections aimed at preserving the organ, combined with chemotherapybefore and/or after the intervention, give good results in the future, even if the level of malignancy is high. Such an approach gives local pronounced control in the case when cancerous processes are localized in the neck, head, torso. The most difficult thing is to treat pathologies in the retroperitoneal space. As a rule, it is impossible or very difficult to remove the focus here, serious restrictions are imposed on the course of irradiation, since it is not always possible to use such doses that are effective against atypical cells.
Nuances of therapy
In certain cases, it is indicated before the operation to undergo a course of application of chemical pharmaceutical products, irradiation. The measures are aimed at reducing the size of the focus, increasing the possibility of carrying out activities with maximum preservation of the organ. Irradiation continues after the operation.
In the fourth stage of cancer, surgery is resorted to if it is possible to remove metastases formed in the lungs from the body. The initial focus is not always operable. Removal of metastases, even if it is impossible to perform an operation in the area of the underlying cause, allows you to increase the survival period. Cases of complete cure are known, although their frequency is quite small. More often this is possible when lung metastases are isolated, localized in such a way that surgical removal is not particularly difficult. The best opportunities in patients who do not have the spread of the oncological process to the mediastinal lymph nodes, there is no pleural effusion. In addition, it is importantno contraindications for surgery in the sternum.
Treatment: choosing a course is not easy
When choosing possible means for chemical drug treatment, the doctor focuses on the features, the type of oncological pathology, the level of malignancy, and the area of localization. The general condition of the patient plays a role. A correctly, well-chosen course, even when the process is running, can significantly increase the patient's survival time, improve the quality of everyday life.
Chemotherapy of cancerous processes localized in soft tissues has been actively changing in recent decades. Today, different approaches to the formation of combinations of drugs are being practiced. A lot of new things have become known about the nuances of the structure and effectiveness of the therapeutic course in certain varieties. Good prospects lie with developments for targeted treatments.
Targeted drugs target molecular targets. The interaction occurs directly in typical cells, while he althy structures remain intact. Active work is underway to assess the effectiveness and safety of the use of such a group of medicines. Prescribing options for many of the newer drugs are expanding, both for use on their own and for inclusion in a combination course.
What to expect?
Prognosis is determined by a complex of factors: age-related characteristics, dimensions of the neoplasm, the level of its malignancy. The stage at which the treatment of the disease began is important. The worst forecasts are characteristic of the case when a person's age exceeds 60 years. Greater risks are associated with the presence of a tumor more than five centimeters in diameter and an increased level of malignancy.
Five-year survival rate for stage 1 is estimated to be over 50%. With the prevalence of the oncological process, the rates drop to 10%, and in some cases even less.
