Sarcoma

Sarcoma Overview and Symptoms

Types of sarcoma include:

• Osteosarcoma - a cancerous tumor of bone
• Chondrosarcoma - cancer of cartilage
• Pleomorphic sarcoma - a group of cancerous soft-tissue or bone tumors
• Liposarcoma - cancer of fatty tissue
• Leiomyosarcoma - cancer of smooth muscle tissue or in the muscle wall of a blood vessel
• Synovial sarcoma - soft tissue cancer (sarcoma) often near a joint, but seldom in a joint
• Ewing's sarcoma - a cancerous bone or soft tissue tumor that often strikes children and young adults

People with soft tissue sarcomas often have no symptoms until the tumor grows to a large size and can be felt. However, when symptoms are present, they may include:

• Pain in the affected area
• Inflammation and swelling in the affected area
• Inability to move limbs properly in the affected area

Sarcoma Diagnosis

If a lump or swelling indicate the possibility of sarcoma, doctors usually will suggest imaging tests:

• X-ray
• CT Scan – also called computed tomography (CT) scan
• magnetic resonance imaging (MRI)
• positron emission tomography (PET) scan

If the imaging tests show the presence of a tumor, doctors will perform a biopsy to determine whether it is a benign (non-cancerous) or malignant (cancerous) tumor. Biopsy can be done through either a needle or surgical incision.

• Image-guided needle biopsy – Musculoskeletal radiology physicians, guided by CT or ultrasound, insert a needle into the tumor to take a small core sample of cells for analysis. A surgeon is also present to help guide the needle's path. This outpatient procedure uses a local anesthetic to numb the area.
• Open biopsy – A surgeon uses a scalpel (surgical knife) to make a small incision and take a wedge of tumor for analysis. This is usually an outpatient procedure, but performed in the operating room with general anesthesia, so you are asleep.

Usually biopsy procedures are not carried out at the initial visit, but arranged for at a later date once all the information and imaging studies have been gathered.

Sarcoma Staging

Staging is the process of determining whether the sarcoma has spread and if so, where. More imaging studies may be necessary. A surgical oncologist may also need to do an outpatient procedure called a sentinel node biopsy. Tumors with a tendency to involve lymph nodes require this type of biopsy. The surgical oncologist injects an area of the tumor with "dye," which is picked up in the lymph nodes. The lymph node(s) that are both the first to absorb the dye and absorb the largest amount are removed and examined to determine if they contain any tumor cells. (If so, the surgeon will remove these lymph nodes during the same or subsequent operation to remove the tumor, to be sure all traces of cancer are gone.)