Sarcoma

Sarcoma is a disease that implies malignant neoplasms of different localization. Let's look at the main types of sarcoma, the symptoms of the disease, the methods of treatment and prevention.

Sarcoma is a group of malignant neoplasms. The disease begins with a lesion of the primary connective cells. Due to histological and morphological changes, a malignant formation starts that develops elements of cells, vessels, muscles, tendons and other things. Among all forms of sarcoma, especially malignant, there are about 15% of new growths.

See also: Treatment of sarcoma

The main symptomatology of the disease manifests itself in the form of a swelling of any part of the body or knot. Sarcoma affects: smooth and striated muscle tissue, bones, nervous, fatty and fibrous tissue. The type of disease depends on the methods of diagnosis and methods of treatment. The most common types of sarcoma are:

• Sarcoma of the trunk, soft tissues of the extremities.
• Sarcoma of the uterus and mammary glands.
• Sarcoma of bones, neck and head.
• Retroperitoneal sarcomas, muscle and tendon lesions.

Sarcoma affects connective and soft tissues. In 60% of the disease, the tumor develops on the upper and lower extremities, 30% on the trunk and only rarely, the sarcoma affects the tissues of the neck and head. The disease occurs in both adults and children. At the same time, about 15% of the case of sarcoma is cancer. Many oncologists consider sarcoma a rare type of cancer requiring special treatment. There are many names of this disease. The names depend on the tissue in which they appear. Sarcoma bone - osteosarcoma, cartilage sarcoma - chondrosarcoma, and the defeat of smooth muscle tissue - leiomyosarcoma.

ICD-10 code

Sarcoma microbial 10 is a classification of the disease by the international disease cataloger of the tenth revision.

ICD-10 International Classification of Diseases Code:

• C45 Mesothelioma.
• C46 Kaposi's sarcoma.
• C47 Malignant neoplasm of peripheral nerves and autonomic nervous system.
• C48 Malignant neoplasm of retroperitoneal space and peritoneum.
• C49 Malignant neoplasm of other types of connective and soft tissue.

Each of the items has its own classification. Let's consider what each of the categories of the international classification of sarcoma diseases of ICD-10 implies:

• Mesothelioma is a malignant neoplasm originating from the mesothelium. Most often affects the pleura, peritoneum and pericardium.
• Kaposi's sarcoma - a tumor develops from blood vessels. The peculiarity of the neoplasm is the appearance on the skin of spots of red-brown color with pronounced margins. The disease is malignant, therefore it poses a threat to human life.
• Malignant neoplasm of peripheral nerves and autonomic nervous system - in this category there are lesions and diseases of peripheral nerves, lower extremities, head, neck, face, thorax, hip region.
• Malignant neoplasm of retroperitoneal space and peritoneum - soft tissue sarcomas affecting the peritoneum and retroperitoneal space, cause thickening of parts of the abdominal cavity.
• Malignant neoplasm of other types of connective and soft tissues - the sarcoma affects soft tissues on any part of the body, provoking the appearance of a cancerous tumor.

Causes of sarcoma

The causes of sarcoma are varied. The disease can arise because of the influence of environmental factors, injuries, genetic factors and much more. The concretization of the cause of the development of the sarcoma is simply impossible. But, there are several risk factors and causes, which most often provoke the development of the disease.

• Hereditary predisposition and genetic syndromes (retinoblastoma, Gardner's syndrome, Werner's syndrome, neurofibromatosis, pigmental basal cell carcinoma multiple skin cancer syndrome).
• Influence of ionizing radiation - tissues exposed to radiation are subject to infection. The risk of a malignant tumor increases by 50%.
• Herpes virus is one of the factors in the development of Kaposi's sarcoma.
• Lymphostasis of the upper extremities (chronic form), developing on the background of radial mastectomy.
• Injuries, wounds, suppuration, exposure to foreign bodies (debris, chips, etc.).
• Polychemotherapy and immunosuppressive therapy. Sarcoma occurs in 10% of patients who underwent this type of therapy, as well as in 75% after organ transplantation operations.

[1], [2], [3], [4], [5], [6], [7], [8]

Symptoms of sarcoma

Symptoms of sarcoma are diverse and depend on the location of the tumor, its biological characteristics and the original causes of the cells. In most cases, the initial symptom of sarcoma is a tumor that grows in size. So, if a patient has sarcoma of bones, that is, osteosarcoma, then the first sign of the disease is terrible pain in the area of bones that occur at night and is not stopped by analgesics. In the process of tumor growth, adjacent organs and tissues are involved in the pathological process, which leads to a variety of painful symptoms.

• Some types of sarcomas (sarcoma of bone, parostal), develop very slowly and asymptomatically for many years.
• But rhabdomyosarcoma is characterized by rapid growth, the spread of the tumor to neighboring tissues and early metastasis, which occurs by hematogenesis.
• Liposarcoma and other types of sarcomas are primarily multi-character, consistently or simultaneously manifested in different places, which complicates the metastasis.
• Soft tissue sarcoma affects the surrounding tissues and organs (bones, skin, vessels). The first sign of soft tissue sarcoma is a tumor without limited contours, causing painful sensations on palpation.
• With lymphoid sarcoma, there is a tumor in the form of a node and a slight swelling in the area of the lymph node. Neoplasm has an oval or round shape with no painful sensations. The size of the tumor can be from 2 to 30 centimeters.

Depending on the type of sarcoma, a fever may appear. If the neoplasm rapidly progresses, the subcutaneous veins appear on the surface of the skin, the tumor acquires a cyanotic color, and the skin can appear. When palpating the sarcoma, the mobility of the tumor is limited. If the sarcoma appears on the limbs, then this can lead to their deformation.

Sarcoma in children

Sarcoma in children - a number of malignant tumors that damage the organs and systems of the child's body. Most often, children are diagnosed with acute leukemia, that is, malignant damage to the bone marrow and circulatory system. In second place in the frequency of diseases - lymphosarcomas and lymphogranulomatosis, tumors in the central nervous system, osteosarcomas, soft tissue sarcomas, tumors of the liver, stomach, esophagus and other organs.

Sarcomas in patients of childhood age arise for several reasons. First of all, it is genetic predisposition and heredity. The second place is the mutations in the child's body, the injuries and injuries suffered, the transferred diseases and the weakened immune system. Diagnosis of sarcomas in children, as well as in adults. To do this, resort to methods of computer and magnetic resonance imaging, ultrasound, biopsy, cytological and histological research.

Treatment of sarcoma in children depends on the location of the tumor, the stage of the tumor, its size, the presence of metastases, the age of the child and the general condition of the body. For treatment, surgical methods of tumor removal, chemotherapy and radiation exposure are used.

• Malignant diseases of lymph nodes

Malignant diseases of the lymph nodes are the third most frequent occurrence of the disease, which occurs in both children and adults. Most often, oncologists diagnose lymphogranulomatosis, lymphoma, lymphosarcoma. All these diseases are similar in their malignancy and substrate of defeat. But between them there are a number of differences, in the clinical course of the disease, the methods of treatment and prognosis. •

• Lymphogranulomatosis

Tumors affect the cervical lymph nodes, in 90% of cases. Most often, this disease affects children under the age of 10 years. This is due to the fact that at this age in the lymphatic system there are major changes at the physiological level. Lymph nodes become very vulnerable to the action of stimuli and viruses that cause certain diseases. With a tumor disease, the lymph nodes increase in size, but are absolutely painless for palpation, the skin over the tumor does not change color.

For the diagnosis of lymphogranulomatosis, a puncture is used and the tissues are sent to a cytological study. Treat malignant disease of lymph nodes with the help of radiation and chemotherapy.

• Lymphosarcoma

Malignant disease that occurs in the lymphatic tissues. According to its course, symptoms and tumor growth rate, lymphosarcoma is similar to acute leukemia. More often, the neoplasm appears in the abdominal cavity, mediastinum, that is, the thoracic cavity, in the nasopharynx and peripheral lymph nodes (cervical, inguinal, axillary). More rarely, the disease affects bones, soft tissues, skin and internal organs.

Symptomatic of lymphosarcoma resembles the symptoms of a viral or inflammatory disease. The patient has a cough, fever and general ailments. With the progression of the sarcoma, the patient complains of swelling of the face, shortness of breath. Diagnose the disease using radiography or ultrasound. Treatment can be prompt, chemotherapy and radiation.

• Renal Tumors

Renal tumors are malignant neoplasms, which, as a rule, are of an innate nature and appear in patients at an early age. The true causes of kidney tumors are unknown. On the kidneys there are sarcomas, leiomyosarcomas, myxosarcomas. Tumors can be circular cell carcinomas, lymphomas or myosarcomas. Most often, the kidneys affect spindle-shaped, round-celled and mixed types of sarcomas. At the same time, the mixed type is considered to be the most malignant type. In adult patients, kidney tumors metastasize extremely rarely, but can reach large sizes. And in patients of childhood, the tumors metastasize, affecting surrounding tissues.

To treat kidney tumors, as a rule, surgical methods of treatment are used. Let's look at some of them.

• Radical nephrectomy - the doctor makes a cut in the abdominal cavity and removes the affected kidney and the surrounding fatty tissue, adrenal glands that adhere to the affected kidney and regional lymph nodes. The operation is performed under general anesthesia. The main indications for nephrectomy: a large size of a malignant tumor, metastasis in regional lymph nodes.
• Laparoscopic surgical intervention - the advantages of this method of treatment are obvious: minimally invasive, short recovery period after surgery, less pronounced postoperative pain syndrome and better aesthetic result. During the operation, several small punctures are made in the skin of the abdomen, through which the video camera is inserted, fine surgical instruments are inserted and the airway is injected by the abdominal cavity to remove blood and excess tissues from the operation area.
• Ablation and thermoablation is the most gentle method of removing kidney tumors. The neoplasm is affected by low or high temperatures, which leads to the destruction of the kidney tumor. The main types of this treatment: thermal (laser, microwave, ultrasonic), chemical (injection of ethanol, electrochemical lysis).

Types of sarcoma

Types of sarcoma depend on the location of the disease. Depending on the type of tumor, certain diagnostic and therapeutic techniques are used. Let's look at the main types of sarcoma:

1. Sarcoma of the head, neck, bones.
2. Retroperitoneal neoplasm.
3. Sarcoma of the uterus and mammary glands.
4. Gastrointestinal stromal tumors.
5. The defeat of soft tissues of extremities and trunk.
6. Desmoid fibromatosis.

Sarcomas arising from hard bone:

• Ewing's sarcoma.
• The Sarcoma the Steam.
• Osteosarcoma.
• Chondrosarcoma.
• Reticulosarcoma.

Sarcomas arising from muscle, fat and soft tissue:

• Kaposi's Sarcoma.
• Fibrosarcoma and skin sarcoma.
• Liposarcoma.
• Soft tissue and fibrous histiocytoma.
• Synovial sarcoma and dermatofibrosarcoma.
• Neurogenic sarcoma, neurofibrosarcoma, rhabdomyosarcoma.
• Lymphangiosarcoma.
• Sarcoma of internal organs.

The group of sarcomas consists of more than 70 different variants of the disease. Sarkom, distinguish and malignancy:

• G1 - low degree.
• G2 is the middle degree.
• G3 - high and extremely high degree.

Let's take a closer look at some types of sarcomas that require special attention:

• Alveolar sarcoma - most often occurs in children and adolescents. Rarely produces metastases, and is a rare type of tumor.
• Angiosarcoma - affects the vessels of the skin and develops from the blood vessels. Occurs in internal organs, often after irradiation.
• Dermatofibrosarcoma is a kind of histiocytoma. It is a malignant tumor that originates from the connective tissue. Most often affects the body, it grows very slowly.
• Extracellular chondrosarcoma is a rare tumor that arises from cartilaginous tissue, localizes in cartilage and grows into bones.
• Hemangiopericytoma - a malignant tumor from the blood vessels. It has the appearance of nodes and most often affects patients under 20 years old.
• Mesenchymoma is a malignant tumor that grows from vascular and adipose tissue. Affects the cavity of the stomach.
• Fibrous histiocytoma is a malignant tumor localized on the limbs and closer to the trunk.
• Schwannoma is a malignant tumor that affects the nerves. Develops independently, rarely gives metastases, affects deep tissues.
• Neurofibrosarcoma - develops from Schwannian tumors around the processes of neurons.
• Leiomyosarcoma - appears from the rudiments of a smooth muscular tissue. Rapidly spreads through the body and is an aggressive tumor.
• Liposarcoma - arises from adipose tissue, localized on the trunk and lower limbs.
• Lymphangiosarcoma - affects the lymphatic vessels, most often occurs in women who have undergone a mastectomy.
• Rhabdomyosarcoma - arises from the striated muscle, develops in both adults and children.

There is a category of sarcoma without additional characteristics. This category includes:

• Kaposi's sarcoma - usually occurs due to the herpes virus. It is often found in patients taking immunosuppressants and HIV-infected. The tumor develops from the dura mater, hollow and parenchymatous internal organs.
• Fibrosarcoma - occurs on ligaments and muscle tendons. It often strikes feet, less often - the head. The tumor is accompanied by ulcers and actively metastasizes.
• Epithelioid sarcoma - affects the peripheral parts of the limbs, in young patients. The disease actively metastasizes.
• Synovial sarcoma - occurs in articular cartilage and near the joints. It can develop from the synovial membranes of the muscles of the vagina, and spread to the bone tissue. Because of this type of sarcoma, the patient has reduced motor activity. Most often occurs in patients from 15-50 years.

Stromal sarcoma

Stromal sarcoma is a malignant tumor that affects internal organs. As a rule, stromal sarcoma affects the uterus, but this disease is a rare phenomenon that occurs in 3-5% of women. The only difference between sarcoma and uterine cancer is the course of the disease, the process of metastasis and treatment. The suggestive sign of the appearance of sarcoma is the passage of a course of radiation therapy for the treatment of pathologies in the pelvic region.

Stromal sarcoma is predominantly diagnosed in patients aged 40-50 years, with menopause, sarcoma occurring in 30% of women. The main symptoms of the disease are manifested in the form of bloody discharge from the genital tract. Sarcoma causes painful sensations due to the increase in the uterus and squeezing its neighboring organs. In rare cases, the stromal sarcoma is asymptomatic, and it can be recognized only after a visit to the gynecologist.

Spindle cell sarcoma

The spindle cell sarcoma consists of spindle-shaped cells. In some cases, histological examination, this type of sarcoma is confused with fibroids. The tumor nodes have a dense consistency, a fibrous structure of white-gray color is visible on the cut. The sarcoma of sarcoma appears on the mucous membranes, skin, serous cover and fascia.

Tumor cells grow randomly alone or in bundles. They are located in various directions relative to each other, intertwining and forming a tangle. The size and location of the sarcoma is varied. With timely diagnosis and rapid treatment has a positive prognosis.

Malignant sarcoma

Malignant sarcoma is a tumor of soft tissues, that is, pathological formation. There are several clinical signs that combine malignant sarcomas:

• Localization is deep in the muscles and subcutaneous tissues.
• Frequent relapse of the disease and metastasis to the lymph nodes.
• Asymptomatic tumor growth for several months.
• The location of the sarcoma in the pseudocapsule and frequent germination beyond its limits.

Malignant sarcoma recurs in 40% of cases. Metastases appear in 30% of patients and most often affect the liver, lungs and brain. Let's look at the main types of malignant sarcoma:

• Malignant fibrous histiocytoma is a tumor of soft tissues, localized in the trunk and extremities. When carrying out an ultrasound, the tumor does not have clear contours, it can lie on the bone or cover the vessels and tendons of the muscles.
• Fibrosarcoma is a malignant formation of connective fibrous tissue. As a rule, it is localized in the area of the shoulder and hip, in the thickness of soft tissues. A sarcoma develops from the intermuscular fascial formations. Metastasizes into the lungs and occurs most often in women.
• Liposarcoma is a malignant sarcoma of adipose tissue with a variety of varieties. It occurs in patients of all ages, but most often in men. It affects limbs, hip tissues, buttocks, retroperitoneal space, uterus, stomach, seminal cord, mammary glands. Liposarcoma can be single and multiple, while developing on several parts of the body. The tumor grows slowly, but can reach very large sizes. The peculiarity of this malignant sarcoma is that it does not germinate in the bones and skin, but it can recur. The tumor gives metastases to the spleen, liver, brain, lungs and heart.
• Angiosarcoma is a malignant sarcoma of vascular origin. It occurs both in men and in women, between the ages of 40-50. It is localized on the lower limbs. The tumor contains blood cysts that become the focus of necrosis and hemorrhage. Sarcoma grows very quickly and is prone to ulceration, can metastasize to regional lymph nodes.
• Rhabdomyosarcoma is a malignant sarcoma, develops from the striated musculature and ranks 3rd among malignant soft tissue lesions. As a rule, it affects the limbs, develops in the thickness of the muscles in the form of a knot. At palpation soft with a dense consistence. In some cases, it causes hemorrhage and necrosis. Sarcoma is quite painful, metastasizes into the lymph nodes and lungs.
• Synovial sarcoma is a malignant soft tissue tumor that occurs in patients of all ages. As a rule, it is localized on the lower and upper extremities, in the region of the knee joints, feet, hips, shins. The tumor has the shape of a knot of round shape, limited from surrounding tissues. Inside the formation there are cysts of different sizes. Sarcoma recurs and can start metastases even after the course of treatment.
• Malignant neurinoma - malignant formation, occurs in men and patients suffering from Recklinghausen disease. The tumor is localized on the lower and upper limbs, head and neck. Metastasizes rarely, can give metastases to the lungs and lymph nodes.

Pleomorphic sarcoma

Pleomorphic sarcoma is a malignant tumor that affects the lower limbs, trunk and other places. In the early stages of development, the tumor is difficult to diagnose, so it is detected by reaching 10 centimeters or more in diameter. Education is a lobed, dense knot, a reddish-gray color. The site contains a zone of hemorrhages and necrosis.

Pleomorphic fibrosarcoma recurs in 25% of patients, gives metastases to the lungs in 30% of patients. Because of the progression of the disease, the tumor often causes death, within a year of the discovery of education. Survival of patients after detection of this formation is 10%.

Polymorphocellular sarcoma

Polymorphocellular sarcoma is a fairly rare autonomous type of primary skin sarcoma. The tumor develops, as a rule, on the periphery of soft tissues, and not in depth, surrounded by the erythematous corolla. During the period of growth, it ulcerates and becomes similar to a gummy syphilide. Metastasizes into the lymph nodes, causes an increase in the spleen, and when squeezing the soft tissue causes a strong pain.

According to the results of histology, it has an alveolar structure, even with reticular carcinoma. The connective tissue network contains rounded and fusiform cells of the embryonic type, similar to megakaryocytes and myelocytes. At the same time, the blood vessels are devoid of elastic tissue and thinned. Treatment of polymorphous cell sarcoma is only operative.

Undifferentiated sarcoma

Undifferentiated sarcoma is a tumor that is difficult or impossible to classify according to the results of histology. This kind of sarcoma is not associated with certain cells, but, as a rule, it is treated as rhabdomyosarcoma. So, malignant tumors of indeterminate differentiation are:

• Epithelioid and alveolar soft tissue sarcoma.
• A light-celled soft tissue tumor.
• Intimal sarcoma and mesenchymoma of malignant type.
• Circular cell desmoplastic sarcoma.
• Tumor with perivascular epithelioid cell differentiation (myomelanocyte sarcoma).
• The extrarenal rhabdoid neoplasm.
• Ewing vnekeleletnaya tumor and extraskeletal myxoid chondrosarcoma.
• Neuroectodermal neoplasm.

Histiocytic sarcoma

Histiocytic sarcoma is a rare malignant neoplasm, of an aggressive nature. The tumor consists of polymorphic cells, in some cases has giant cells with a polymorphic nucleus and a pale cytoplasm. Cells of histiocytic sarcoma are positive when tested for nonspecific esterase. The prognosis of the disease is unfavorable, since generalization occurs quickly.

Histiocytic sarcoma is characterized by a rather aggressive course and a poor response to therapeutic treatment. This type of sarcoma causes extranodal lesions. This pathology undergoes the gastrointestinal tract, soft tissues and skin. In some cases, the histiocytic sarcoma affects the spleen, central nervous system, liver, bone and bone marrow. During the diagnosis of the disease, immunohistological examination is used.

Round cell sarcoma

Circular cell sarcoma is a rare malignant tumor consisting of round cellular elements. The cells contain hyperchromic nuclei. Sarcoma corresponds not to the mature state of connective tissue. The tumor is rapidly progressing, so it is extremely malignant. There are two types of circulatory cell sarcoma: small-cell and large-cell (the species depends on the size of the cells that make up its composition).

According to the results of the histological examination, the neoplasm consists of round cells with poorly developed protoplasm and a large nucleus. Cells are located close to each other, do not have a certain order. There are contiguous cells and cells separated from each other by thin filaments and pale-colored amorphous mass. Blood vessels are located with connective tissue layers and tumor cells that are adjacent to its walls. The tumor affects the skin and soft tissues. Sometimes, with the lumen of the vessels, it is possible to see the tumor cells that have implanted into healthy tissues. The tumor metastasizes, recurs and causes necrosis of affected tissues.

Fibromixoid sarcoma

Fibromixoid sarcoma is a neoplasm with a low degree of malignancy. The disease affects both adults and children. Most often, the sarcoma is localized in the area of the trunk, shoulders and hips. The tumor rarely metastasizes and grows very slowly. The reasons for the emergence of fibromyxoid sarcoma include hereditary predisposition, trauma to soft tissues, the effect on the body of large doses of ionizing radiation and chemicals that have a carcinogenic effect. The main symptomatology of fibromyxoid sarcoma:

• There are painful seals and tumors in the soft tissues of the trunk and extremities.
• In the field of neoplasm appear painful sensations, and sensitivity is disturbed.
• The integuments acquire a bluish-brown color, and with increasing neoplasm, compression of the vessels and ischemia of the extremities occurs.
• If the neoplasm is localized in the abdominal cavity, the patient has pathological symptoms from the gastrointestinal tract (dyspeptic disorders, constipation).

The general symptoms of fibromyxoid sarcoma are manifested in the form of unmotivated weakness, weight loss and lack of appetite, which lead to anorexia, as well as frequent fatigue.

[9], [10], [11], [12], [13], [14], [15]

Lymphoid sarcoma

Lymphoid sarcoma is a tumor of the immune system. The clinical picture of the disease is polymorphic. Thus, in some patients lymphoid sarcoma manifests itself in the form of lymph node enlargement. Sometimes the symptoms of the tumor manifest themselves in the form of autoimmune hemolytic anemia, eczematous rashes on the skin and poisoning. Sarcoma begins with a syndrome of squeezing lymphatic and venous vessels, which leads to a disruption of the functions of the organs. In rare cases, the sarcoma causes necrotic lesions.

Lymphoid sarcoma has several forms: localized and local, common and generalized. From the morphological point of view, lymphoid sarcoma is divided into: large cell and small cell, that is, lymphoblastic and lymphocytic. The tumor affects the lymph nodes of the neck, retroperitoneal, mesenteric, less often - axillary and inguinal. Neoplasm can also occur in organs that contain lymphoreticular tissue (kidneys, stomach, tonsils, intestines).

To date, there is no single classification of lymphoid sarcomas. In practice, the international clinical classification, which was adopted for lymphogranulomatosis:

1. Local stage - affected lymph nodes in one area, have extranodal localized lesion.
2. Regional stage - the lymph nodes in two or more zones of the body are affected.
3. The generalized stage - the lesion appeared on either side of the diaphragm or spleen, the extrasodal organ is touched.
4. Disseminated stage - sarcoma progresses on two or more ectranodal organs and lymph nodes.

Lymphoid sarcoma has four stages of development, each of which causes a new more painful symptomatology and requires prolonged chemotherapy for treatment.

Epithelioid sarcoma

Epithelioid sarcoma is a malignant tumor that affects the distal parts of the limbs. The disease is most often found in patients of a young age. Clinical manifestations suggest that epithelioid sarcoma is a type of synovial sarcoma. That is, the origin of the neoplasm is a controversial issue among many oncologists.

The disease got its name because of rounded cells, large epithelioid forms that resemble a granulomatous inflammatory process or squamous cell carcinoma. New growth manifests itself in the form of a subcutaneous or intradermal nodule or multi-site mass. The tumor appears on the surface of the palms, forearms, hands, fingers, feet. Epithelioid sarcoma is the most common soft tissue tumor of the upper limbs.

The sarcoma is treated by the method of surgical excision. This treatment is explained by the fact that the neoplasm spreads along the fascia, blood vessels, nerves and tendons. Sarcoma can give metastases - nodules and plaques along the forearm, metastases in the lungs and lymph nodes.

[16], [17], [18], [19], [20], [21], [22], [23], [24], [25]

Myeloid sarcoma

Myeloid sarcoma is a local neoplasm consisting of leukemic myeloblasts. In some cases, before myeloid sarcoma, patients experience acute myeloblastic leukemia. Sarcoma can act as a chronic manifestation of myeloid leukemia and other myeloproliferative lesions. The tumor is localized in the bones of the skull, internal organs, lymph nodes, tissues of the mammary glands, ovaries, gastrointestinal tract, tubular and spongy bones.

Treatment of myeloid sarcoma consists of chemotherapy and local radiation therapy. The tumor lends itself to antileukemic treatment. The tumor rapidly progresses and grows, which determines its malignancy. Sarcoma metastasizes and causes disturbances in the work of vital organs. If the sarcoma develops in the blood vessels, then the patients have irregularities in the hemopoietic system and anemia develops.

Clear cell sarcoma

Clear cell sarcoma is a malignant fasciogenic tumor. Neoplasm, as a rule, is localized on the head, neck, trunk and affects soft tissues. The tumor is a dense knots of round shape, in diameter from 3 to 6 centimeters. When histologically examined, it was determined that the tumor nodes are gray-white in color and anatomical connection. The sarcoma develops slowly and is characterized by long-term long-term course.

Sometimes, a clear cell sarcoma appears around or inside the tendons. The tumor often recurs and gives metastases to the bones, lungs and regional lymph nodes. Sarcoma is difficult to diagnose, it is very important to differentiate it from the primary melanoma of a malignant species. Treatment can be carried out by surgical methods and methods of radiotherapy.

[26], [27], [28], [29], [30], [31], [32], [33], [34], [35], [36]

Neurogenic sarcoma

Neurogenic sarcoma is a malignant neoplasm of neuroectodermal origin. The tumor develops from the Schwannian membrane of peripheral nerve elements. The disease is extremely rare, in patients aged 30-50 years, usually on the limbs. According to the results of the histological examination, the tumor is round, large-hummocky and encapsulated. Sarcoma consists of spindle-shaped cells, the nuclei are located in the form of a stockade, cells in the form of spirals, nests and bundles.

The sarcoma develops slowly, with palpation causes painful sensations, but is well limited by surrounding tissues. Sarcoma is located along the nerve trunks. Treatment of a tumor is only surgical. In particularly severe cases, excision or amputation is possible. The methods of chemotherapy and radiotherapy, in the treatment of neurogenic sarcoma, are ineffective. The disease often recurs, but has a positive prognosis, the survival rate among patients is 80%.

Sarcoma bone

Bark sarcoma is a rare malignant tumor of various localizations. Most often, the disease appears in the area of the knee and shoulder joints and in the pelvic region. The cause of the disease can be trauma. Exostoses, fibrous dysplasia and Paget's disease are another cause of bone sarcoma. Treatment involves methods of chemotherapy and radiation therapy.

Sarcoma muscle

Sarcoma muscle is very rare and most often affects younger patients. In the early stages of development, the sarcoma does not manifest itself and does not cause painful symptoms. But the tumor gradually expands, causing swelling and painful sensations. In 30% of cases of muscle sarcomas, patients experience abdominal pain, associating it with problems with the gastrointestinal tract or menstrual pain. But soon, the pain begins to be accompanied by bleeding. If the muscle sarcoma has arisen on the limbs and begins to increase in size, then it is easiest to diagnose it.

Treatment completely depends on the stage of development of the sarcoma, size, metastasis and degree of spread. For treatment, surgical methods and radiation are used. The surgeon removes the sarcoma and part of the healthy tissue around it. Irradiation is used both before the operation and after, to reduce the tumor and destroy the remaining cancer cells.

Sarkoma Skin

Sarcoma of the skin, is a malignant lesion, the source of which is connective tissue. As a rule, the disease occurs in patients aged 30-50 years. Localized tumor on the trunk and lower limbs. The causes of the appearance of sarcoma are chronic dermatitis, trauma, prolonged lupus, scars on the skin.

The sarcoma of the skin is most often manifested in the form of solitary neoplasms. The tumor can appear both on the intact dermis, and on zarubtsovanoy skin. The disease begins with a small solid nodule, which gradually increases, acquiring the wrong outlines. The new growth grows towards the epidermis, germinating through it, causing ulceration and inflammation.

This type of sarcoma metastasizes much less frequently than other malignant tumors. But with the defeat of lymph nodes, the patient's death occurs 1-2 years later. Treatment of skin sarcoma involves the use of chemotherapy, but surgical treatment is considered more effective.

Sarcoma of the lymph nodes

Sarcoma of lymph nodes is a malignant neoplasm that is characterized by destructive growth and arises from lymphoreticular cells. Sarcoma has two forms: local or localized, generalized or common. From a morphological point of view, sarcoma of lymph nodes is: lymphoblastic and lymphocytic. Sarcoma affects the lymph nodes of the mediastinum, neck and peritoneum.

The symptomatology of sarcoma is that the disease is growing rapidly and increasing in size. The tumor is easily palpable, the tumor nodes are mobile. But because of abnormal growth, they can acquire limited mobility. Symptomatic of sarcomas of lymph nodes depends on the degree of lesion, stage of development, localization and general condition of the body. Diagnosis of the disease using ultrasound and X-ray therapy. In the treatment of sarcoma of lymph nodes, methods of chemotherapy, radiation exposure and surgical treatment are used.

Sarcoma of vessels

Sarcoma of vessels has several varieties, which differ in nature of origin. Let's look at the main types of sarcomas and malignant tumors that affect the vessels.

• Angiosarcoma

It is a malignant tumor that consists of a cluster of blood vessels and sarcomatous cells. The tumor quickly progresses, is capable of disintegration and profuse bleeding. Neoplasm is a dense, painful knot of dark red color. At the initial stages, angiosarcoma can be taken for hemangioma. Most often this kind of vascular sarcoma occurs in children older than five years.

• Endothelioma

Sarcoma originating from the inner walls of the blood vessel. Malignant neoplasm has several layers of cells that can close the lumen of blood vessels, which complicates the diagnostic process. But the final diagnosis is made by histological examination.

• Periteliaoma

Hemangiopericytoma originating from the external vascular membrane. The peculiarity of this type of sarcoma is that sarcomatous cells grow around the vascular lumen. A tumor can consist of one or more nodes of different sizes. The skin over the tumor becomes blue.

Treatment of vascular sarcoma involves surgical intervention. After the operation, the patient is given a course of chemotherapy and radiation to prevent recurrence of the disease. The prognosis for sarcomas of vessels depends on the type of sarcoma, its stage and the way of treatment.

Metastases in sarcoma

Metastases in sarcoma are secondary foci of tumor growth. Metastases are formed as a result of detachment of malignant cells and their penetration into blood or lymphatic vessels. With blood flow, the affected cells ply through the body, stopping anywhere and forming metastases, that is, secondary tumors.

Symptomatic of metastases completely depends on the location of the tumor. Most often, metastases occur in nearby lymph nodes. Metastases progress, affecting the organs. The most common places for the appearance of metastases are bones, lungs, brain and liver. For the treatment of metastases, it is necessary to remove the primary tumor and the tissues of the regional lymph nodes. After this, the patient undergoes a course of chemotherapy and radiation exposure. If metastases reach large sizes, then they are removed surgically.

Diagnosis of sarcoma

Diagnosis of sarcoma is extremely important, as it helps to establish the location of malignant neoplasm, the presence of metastases, and sometimes the causes of the tumor. Diagnosis of sarcoma is a complex of different methods and techniques. The simplest diagnostic method is visual inspection, which includes determining the depth of the tumor placement, its mobility, size, consistency. Also, the doctor should examine the regional lymph nodes for the presence of metastases. In addition to visual inspection, the following are used to diagnose sarcoma:

• Computer and magnetic resonance imaging - these methods provide important information about the size of the tumor and its relationship with other organs, nerves and main vessels. Such diagnostics is carried out for pelvic and limb tumors, as well as sarcomas located in the sternum and abdominal cavity.
• Ultrasonography.
• Radiography.
• Neurovascular examination.
• Radionuclide diagnostics.
• Biopsy is the taking of sarcoma tissue by histological and cytological studies.
• Morphological study - is conducted to determine the stage of sarcoma, the choice of treatment tactics. Allows to predict the course of the disease.

[37], [38], [39], [40], [41], [42], [43]

Sarcoma on ultrasound

Sarcoma on ultrasound is a diagnostic method that allows you to visually see the size of the tumor, the presence of metastases and other features of it. Ultrasound examination makes it possible to put a presumptive diagnosis. This is due to the fact that in certain cases, (early stages, some types of sarcomas and localization sites), ultrasound can not be seen. Ultrasound is not performed for the diagnosis of sarcoma of hollow organs. But such a study makes it possible to determine the tumor by secondary signs (enlarged lymph nodes, secondary metastases).

That is, ultrasound is an auxiliary diagnostic method. Sarcoma on ultrasound looks different on different organs and at different stages of development. So, for example, the kidney sarcoma looks like a small nodule, and the sarcoma of the pancreas has uneven contours, and the lobes of the organ are slightly enlarged, the sarcoma of the lungs looks like a small coin.

Prophylaxis of sarcoma

Prevention of sarcomas is carried out in two directions, this is a prevention of the development of malignant neoplasms and prevention of metastasis and relapses of the disease. The first rule of sarcoma prevention is the fight against premature exhaustion of the body and aging. To do this, you need to eat right, lead an active lifestyle, avoid stress and relax.

Do not forget about the timely treatment of specific inflammatory diseases, which can take a chronic form (syphilis, tuberculosis). Hygienic measures are a guarantee of normal functioning of separate organs and systems. It is mandatory to treat benign tumors that can degenerate into sarcomas. And also, warts, ulcers, seals in the mammary gland, tumors and stomach ulcers, erosions and cervical cracks.

Prophylaxis of sarcomas should include not only the implementation of the above methods, but also the passage of preventive examinations. Women should visit every 6 months of the gynecologist, to detect and timely treatment of lesions and diseases. Do not forget about the passage of fluorography, which allows you to identify lesions of the lungs and chest. Observance of all the above methods is an excellent prophylaxis of sarcoma and other malignant tumors.

Prognosis of sarcoma

Prognosis of sarcoma depends on the location of the tumor, the origin of the tumor, the rate of growth, the presence of metastases, tumor volumes and the general condition of the patient's body. The disease is distinguished by the degree of malignancy. The higher the degree of malignancy, the worse the prognosis. Do not forget that the prognosis depends on the stage of the sarcoma. At the first stages the disease can be cured without damaging consequences for the body, but the last stages of malignant tumors have a poor prognosis for the patient's life.

Despite the fact that sarcomas are not the most common oncological diseases that can be treated, sarcomas are prone to metastasis, affecting vital organs and systems. In addition, sarcomas can recur, again and again affecting the weakened body.

Survival in sarcoma

Survival in sarcoma depends on the prognosis of the disease. The more favorable the forecast, the higher the patient's chances for a healthy future. Very often, sarcomas are diagnosed at late stages of development, when a malignant tumor has already metastasized and affects all vital organs. In this case, the patients' survival is from 1 year to 10-12 years. Survival depends on the effectiveness of treatment, the more successful the therapy, the more likely that the patient will live.

Sarcoma is a malignant tumor, which is considered to be the cancer of the young. The disease is susceptible to everything, both children and adults. The danger of the disease is that at first, the symptoms of sarcoma are insignificant and the patient may not even know that a malignant tumor is progressing. Sarcomas are diverse in origin and histological structure. There are many types of sarcomas, each of which requires a special approach in diagnosis and treatment.