Sarcoma of the leg is one of the most common forms of sarcoma found in humans. Up to 70% of this type of cancer occurs in the extremities. In some, the localization area is the foot, the thigh is often found, although other areas may also be affected. In the main percentage of cases, the disease is asymmetric, that is, malignant processes occur in only one leg.
General information
Sarcoma is a malignant tumor, the mechanism of development of which, the nuances of formation and treatment features have attracted the attention of specialists for quite a long time. The disease belongs to the category of non-epithelial, most often it affects the limbs. There is a possibility of a primary or secondary pathological process. In some cases, the cause of sarcoma is metastases that have spread from an earlier focus of development of atypical cells. It is known from statistics that when a limb is affected, the articular areas are most often the first to suffer: the hip joint and knees.
Nuances of hip injury
Among other occasionsmalignant diseases often found femoral sarcoma. What kind of disease is best explained by an oncologist. At first, the process is characterized by a complete absence of symptoms, so the identification of femoral sarcoma at the initial stage is difficult. In fact, this is a bone node. An alternative growth option is along the thigh bone. Muscle masses hide pathological processes, and they usually attract attention only when the size of the tumor becomes very large, which provokes protrusion of soft structures.
As the sarcoma grows, it compresses the nerve endings in this area. Since this leads to quite a lot of pain, traditional medicine recommends using hemlock for cancer - this herb is believed to help ease the pain and cure the root cause. In fact, discomfort and pain, especially pronounced when moving, is a reason to get to the doctor as soon as possible and start a full-fledged treatment in accordance with the latest medical developments.
Progression of condition
As the sarcoma grows, atypical cells may spread to the hip or knee. Joint sarcoma is called chondroosteosarcoma. The patient loses the ability to move normally, the ability to bend the leg gradually disappears completely. The limb constantly hurts, the patient limps. Unpleasant sensations become stronger during the night's rest.
A lot of effort and money was spent by specialists to establish what kind of disease it is. Sarcoma, as you know, often affects soft tissues, over time disrupts the functioning of the circulatory system, as it compresses the vessels. The disease occurs quite often, so scientists have a large base of observations. Unfortunately, it is not yet possible to say that it was possible to identify all the causes of the pathology and methods of its treatment, symptoms and manifestations. It is known that congestion in the lower regions of the diseased leg can indicate sarcoma. Sometimes, with a malignant neoplasm, for the first time, a patient goes to the clinic with complaints of a constant feeling of a cold leg. The skin is pale, the leg swells, trophic ulcers may appear.
Localization - stop
This form of malignant pathology is also quite common. The osteogenic type usually manifests itself as a slight protrusion. When confirming the diagnosis at the appointment, the doctor will definitely explain to the patient what a sarcoma is and how it manifests itself: it has been established that ulcerated difficult-to-heal areas, pain during any movements and skin atrophy indicate a malignant disease of the foot. The peculiarity of the development of a malignant neoplasm in the foot is due to the abundance of ligaments, nerve fibers, and blood vessels in this part of the body. This leads to the rapid spread of abnormal cells to soft tissues.
Sarcoma of the toe, as statistics show, the osteogenic form of the disease, soft tissue damage - all these forms of cancer appear quite quickly, which means that the prognosis is on average better if the patient at the first symptomatology applied forhelped to make an accurate diagnosis. Gradually, the disease spreads to the ankle joint. This progress is indicated by severe pain and limited mobility. The defeat of the foot and soft tissues is accompanied by a change in skin tone and numerous subcutaneous hematomas. Non-healing ulcers form. The disease is characterized by early severe pain syndrome. Its intensity increases as the neoplasm grows.
The nuances of manifestations
Finding out what sarcoma is and how it manifests itself, scientists have found that with the osteogenic form of the disease, there are practically no symptoms at first. As a rule, the disease is detected when the tumor is already large enough to be seen visually. Severe pain and a change in gait, a violation of freedom of movement can indicate sarcoma. In some patients, the progress of the condition is accompanied by fever and fever, weight loss. The patient gets tired quickly. There may be a tendency to fracture. The disease is characterized by the active spread of metastases throughout the body.
Therapy: basic information
Radiation therapy for leg cancer is accompanied by chemotherapy, but both of these approaches are considered secondary: the main intervention is surgery. Operating a patient using the most modern technologies in an impressive percentage of cases allows saving organs. The prognosis is better for those who went to the hospital at an early stage, and the diagnosis was made quickly and accurately. With the prevalence of the process, urgent amputation is required, after which studies are carried out to detect metastases. If anyare identified, a course of radiation and drug therapy is prescribed.
Often, even before the operation, chemotherapy and radiation therapy are prescribed for cancer. The main objective of these measures is to stabilize the condition, reduce the likelihood of metastases. The use of radiotherapy after surgery reduces the risk of disease recurrence.
Hip hurts: nuances of the case
Sarcoma of the leg most often affects the femur. The progress of the disease in most cases is relatively slow, but does not manifest itself as symptoms. If a malignant neoplasm is suspected, the patient is sent for a biopsy. Primary suspicion is possible on the basis of the patient's complaints and palpation of the affected area. There are many cases where the disease could be detected at an early stage, which significantly improved the prognosis of the case.
However, there is still a high incidence of patients presenting to the clinic with stage 4 sarcoma. At this stage, it is extremely difficult to achieve a complete cure, and the main task of doctors is to provide the patient with the longest possible life with the preservation of its quality, as far as possible, taking into account current technologies. The prognosis for each specific case is determined by the size of the tumor and the area of its localization, the stage of the disease and the presence and prevalence of metastases. In many ways, survival depends on the age of the patient.
Hip Cancer
From the statistics on oncology treatment in Moscow, other large cities of Russia, as well as based on the clinical practice of Israeli,German doctors and specialists from other countries, we can conclude that this form of cancer is more often observed in men, but among the female half of humanity, cases are less common. Age dependence was not revealed: hip lesion can occur in any person. The percentage of poor quality, the likelihood of spread to other organs are exceptionally high. The tumor progresses quite quickly. It is extremely difficult to identify it at the first stage. Scientists have found that the first sign of bone sarcoma of this form is a short-term fever, but patients usually do not pay attention to it; the reason to come to the clinic is prolonged soreness, discomfort in movements that appear as the condition worsens.
With a superficial location of the neoplasm, the formation of a relatively small protruding area against the background of thinning of the skin is possible. The neoplasm compresses structures nearby, preventing normal functioning. Soreness worries not only in the area of tumor localization, but also in the thigh, inguinal areas.
Localization Forms
Possible leg sarcoma of one of two forms: osteogenic or affecting soft tissues. In case of violation of the integrity of soft tissues, the definition of the disease is usually not a serious difficulty - the neoplasm is almost immediately noticeable even to the naked eye. The area of the tumor attracts attention with hemorrhages, wounds, and an abnormal shade of the skin. The supporting function of the foot is inhibited, the person cannot move normally.
The osteogenic form of the disease affects the bone and is located deep, although in some cases, soon after the onset of the progress of the condition, a tumor can be seen with the naked eye. Pain in the leg and limited mobility indicate the need to undergo diagnostics. The disease can progress rapidly if abnormal cells spread to the blood vessels, nervous system, and ligaments near the bones of the feet.
Shin cancer
In this form, the sarcoma of the leg disrupts the functionality of soft tissues in the first place. This is a non-epithelial process, usually localized in the back of the leg. At first, it is almost impossible to notice the disease, since the tumor is hidden by the calf muscle. If the localization is the lower leg in front, the progress of the disease is accompanied by the formation of a visually visible protrusion, which simplifies the timely detection of pathology. In this area, the shade and structure of the skin will soon change.
When the calf form, the fibula and tibia are the first to suffer. Tumors are characterized by a tendency to spread, disruption of the integrity of the connecting interosseous membrane. This may cause a fracture. As the neoplasm develops, the nerve fibers and vessels nearby are compressed, which causes pain. Sensations cover the foot, fingers. The trophism of the skin is disturbed, puffiness worries.
Where did the trouble come from?
Several causes of sarcoma are known: radiation exposure, exposure to carcinogens - asbestos, preservatives, and other dangerous and toxic compounds. In some cases, cancer is explainedhereditary factor or previous diseases of the skeletal system. Currently, scientists cannot say with certainty that it was possible to determine the complete list of causes of sarcoma. Presumably, a number of factors have yet to be identified, and research in this area is ongoing.
Clarification
Diagnosis of sarcoma involves a comprehensive study of the patient's condition. First, tissue samples are taken for histological examination. Based on the results of the biopsy, it is accurately assessed whether there is tissue malignancy. A lot of useful information can be obtained from an x-ray of the diseased area, osteoscintigraphy. Mandatory diagnostic steps are CT and MRI.
During these instrumental analyzes, it is possible to determine the exact localization of the neoplasm, its dimensions. To clarify the state of the circulatory system in the diseased area, angiography is prescribed.
Osteogenic sarcoma: features
This form of the disease has been attracting the attention of prominent scientists and doctors around the world for several years now. Clinics in our country will not be an exception: oncology treatment in Moscow at leading research institutes makes it possible to determine more precise nuances of the disease, the features of its progress, and, therefore, the specifics of the therapeutic course. It has been established that in the osteogenic form, atypical cells are formed by bone tissue, and it is this that they generate in the process of life. Perhaps the presence of chondroblastic components or the predominance of fibroblastic. It is customary to talk about sclerotic, osteolytic andmixed types of illness. In any of the forms, the pathology is one of the most malignant, it develops rapidly and forms metastases early.
Osteogenic sarcoma is a designation first used in 1920. The author of the term is James Jung.
Statistics and nuances of distribution
Up to 65% of osteosarcoma patients are in the 10-30 age group. More likely to develop atypical cells by the end of puberty. The incidence among men is twice that of women. The main area of localization is tubular long bones. Approximately every fifth case is a lesion of short or flat bones. The legs are affected more often than the arms, about six times. Up to 80% of all cases occur on the knees.
Thigh, tibia, humerus, pelvis, fibula, shoulder girdle, elbow are among the most common sites (listed as frequency decreases). Very rarely, the disease is observed in the radius - this area is more typical of a giant cell tumor. There are practically no cases when atypical cells would be localized in the patella.
Localization and Features
Among children, there is a possibility of damage to the skull, but at an older age, sarcoma in this area practically does not occur. In old age, there is a risk of disfiguring dystrophy of the skeletal system. In a long tubular bone, atypical cells are most often located at the meta-epiphyseal end, and before synostosis, in the metaphysis. If the localization is the femur, then more oftenthe distal end suffers, but every tenth case occurs in the diaphysis. In the tibia, the malignant tumor is usually formed in the medial proximal condyle. In the shoulder - rough areas of the deltoid muscle.
Development of pathology
In an impressive percentage of cases, it is not possible to determine the moment of onset of the disease. As a rule, the patient first notices a dull soreness in the articular region; the origin of the syndrome is unclear. Studies show that this is often due to damage to the metaphyseal region. There is no effusion in the joint, pain is localized in the joint, often against the background of previous injuries.
Gradually, the tumor progresses, neighboring tissues are affected by atypical cells, the pain becomes stronger. In studies, one can see a noticeable increase in the thickness of the metadiaphyseal bone section. The tissues become pasty, the skin venous network is clearly visible. Articular contracture is observed, the patient limps heavily, palpation is accompanied by sharp pain. Often it is at this stage that a person seriously thinks about his condition. Many, however, do not turn to a classic clinic, but to healers who recommend using hemlock for cancer. This results in a significant loss of time.
The pain gradually gets worse at night, analgesics do not help. Even the imposition of a plaster cast does not relieve the pain. The neoplasm grows rapidly, covers nearby tissues, fills the spinal canal and infiltrates muscle fibers. Osteogenic sarcoma is prone to hematogenous metastases. More oftenall those are determined in the respiratory system and the brain. Exceptionally rare metastasis involves the bones.
X-ray examination: nuances
At the initial stage, the picture shows osteoporosis, the blurring of the contours of the neoplasm. The disease is localized in the metaphysis and does not spread beyond it. Gradually, the development of a defect in bone tissue is observed. Osteoblastic, proliferative processes are possible. The periosteum exfoliates, swells, takes the form of a spindle or peak.
In childhood, the likelihood of needle periostitis is higher. This is a condition in which osteoblasts generate bone tissue in the circulatory system at right angles to the cortex. The process is accompanied by the formation of spicules. Differential diagnosis is designed to distinguish between osteoblastoclastoma, granuloma, cartilage exostosis and chondrosarcoma.
Therapeutic approach
Of course, with sarcoma, surgery is the main stage in the treatment of the patient. Before surgery, chemical treatment is prescribed in order to prevent the development and suppress already formed microscopic metastases, if any are present or are suspected in the lungs. Chemotherapy is also aimed at reducing the size of the primary focus of the disease. Based on the progress of the condition, it is determined how the tumor reacts to various chemical agents - this helps to choose the appropriate long-term program.
In osteogenic sarcoma, "Methotrexate" is actively used in high dosage, as well as platinummedicines and "Etopozid". Often the course includes "Ifosfamide", "Adriblastin". It is impossible to avoid surgery for sarcoma. Some time ago, the only option was an extensive intervention, in which the limb was amputated, but in recent years, more sparing options have been resorted to, removing elements of the skeletal system and replacing them with plastic, metal implants or cadaveric bones.
An organ-sparing operation is not possible if the tumor has affected a bundle of nerves and blood vessels, if a pathological fracture is detected. It will not be possible to save the limb with large dimensions of the malignant site and infiltration into soft tissues. The presence of metastases does not belong to the number of contraindications to a sparing operation. If large metastases are found in the respiratory system, another operation is prescribed to remove them.
Nuances of treatment
Chemical treatment after surgery is prescribed based on the results of the use of drugs before surgery. Radiation treatment in most cases shows too low effectiveness. This is due to the specifics of atypical cells: in osteogenic sarcoma, sensitivity to ionizing radiation is rather low. Irradiation is given to a patient if surgery is not possible.
What to expect?
Prognosis of life in sarcoma is largely determined by the stage at which the patient sought help, as well as the methods used for treatment. Recently, the latest neoadjuvant, adjuvant agents of chemic altreatment, radiotherapy. In combination with a properly performed operation, this helps to achieve a high percentage of survival. Patients with respiratory metastases are now much more likely to survive.
Radical sparing surgery is shown on average in 80% of cases. Chemotherapy before and after surgery, qualified surgery - such a complex helps to achieve the best result. With the localized form, the five-year survival rate is estimated at 70% or even higher. With a high sensitivity of the tumor to drugs, the survival rate reaches 90.
