Sarcomas are the malignant tumors of connective tissues. They can be grouped into two main types, soft tissue sarcomas and bone sarcomas (bone cancer), both of which are further divided into several subtypes based on their possible cell types of origin. More than one third of soft tissue sarcomas occur in the legs. This type of sarcomas can invade tissue around the original site and can metastasize to other organs, while some soft tissue sarcomas are non-cancerous. The second type of sarcoma includes: osteosarcoma, Ewing’s sarcoma and chondrosarcoma, which are usually diagnosed in children. The treatment of sarcomas depends on the size, location, type and grade of the disease. Besides surgery, chemotherapy and radiation therapy as the traditional treatment options, some innovative biological therapies are also used to activate the potential of the immune system, or being carried out in clinical trials for treating soft tissue sarcomas. Research reports indicate people with genetic abnormalities, or have been exposed to high dose of radiation, cancerigenic chemical are always at a more potential risk of developing this disease.

The subtypes of sarcomas are listed here:

Osteosarcoma TOP

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Overview

As the most common type of bone cancer in male adolescents and young adults between the ages of 10 and 25, osteosarcoma originates most often from the wide ends of long bones, such as the femur, tibia in the leg, and the humerus in the upper arm. The tumor is highly malignant and can spread rapidly to other bones or/and to the lungs. Despite surgery and combination chemotherapy improvements in outcome during the last 30 years for patients with local disease, the 5-year survival rate of the sufferers with this metastatic disease remains low. CAR-T cells therapy is an attractive approach to overcome the limitation caused by the low HER2 expression level of this disease, as the engagement of a limited number of modified T-cell receptor molecules would be sufficient to trigger a cytotoxic anti-tumor effect response.

Signs, symptoms and treatments

Symptoms of osteosarcoma may be present at the tumor site, such as sharp or dull pain, welling, limping, decreased joint motion. However, the symptoms are common to other health problems, which make the diagnosis of osteosarcoma to be challenging. So it always takes weeks to months to get the diagnosis after the symptoms appearing.

Ewing’s sarcoma TOP

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Overview

Ewing sarcoma is a very rare form of cancerous bone tumor, which is consisted of three types and it arises primarily in bone or in soft tissue around bone—often the legs, pelvis, arms or spine. Ewing sarcoma can spread quickly to lungs, kidneys, heart, other bones and bone marrow. The disease cases are mostly found in teenagers, particularly Caucasian young males. Although it does not show to be inherited, the cause of Ewing sarcoma is genetic, chromosome changes, in a process known as translocation, chromosomes 11 and 22 exchange small fragment of each other. Normally, DNA assay can detect the abnormal gene.

Signs, symptoms and treatments

The symptoms of Ewing’s sarcoma include swelling at the site fo the tumor, low fever, bone pain and weight loss, however, depending on the tumor size and whether or not the disease has spread, the signs will vary. Chemotherapy is usually to be the first step in treating Ewing sarcoma to shrink the tumor size so as to make sure the following surgery to be most effective.

Chondrosarcoma TOP

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Overview

The disease is a rare type of malignant tumor which mimics the cartilage that coats the ends of bones and spreads to the surrounding bone tissue. It can appear in any part of the body where cartilage is present. However, chondrosarcoma begins most often in the bones of the upper arm, shoulder, ribs and pelvis, particularly the hipbone and thighbone. Some chondrosarcoma develops very fast, while some grows slowly with less severe symptoms, or even no spreading. The exact reason causes this disease is still not very clear, researchers find two genes, called IDH1 and IDH2, may be related to the development of chondrosarcoma.

Signs, symptoms and treatments

The indications of this disease may include a bony lump or mass, pain or swelling, tenderness or stiffness at the site of the tumor, problems with movement or range of motion in the affected limb, however, chondrosarcoma does not usually cause sickness or weakness. The main and preferred treatment option for chondrosarcoma is surgery to remove the tumor. But adjuvant therapies such as radiotherapy, chemotherapy or proton therapy may be also used for dedifferentiated or mesenchymal chondrosarcoma and other higher-grade tumors.

Rhabdomyosarcoma TOP

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Overview

Rhabdomyosarcoma in children is a rare cancerous tumor that arises in the soft tissue of the body, includes muscles, fibrous tissues, tendons, blood vessels, and synovial tissues. There are two major types of rhabdomyosarcoma: Embryonal and Alveolar. The former is diagnosed most often in children younger than 5, or even be present at birth, which often affects the head and neck, bladder, vagina or prostate and testicles, usually with an abnormality of chromosome 11. The later type, which is seen at any age, often affects the large muscles of the arms, legs and trunk. The chromosome material rearrangement between chromosomes 2 and 13 may be the possible reason, which involves the disfunction of two genes, PAX3 and FKHR. For unclear mechanism, females are affected slightly less than males.

Signs, symptoms and treatments

Similar to other cancers, the rhabdomyosarcoma symptoms vary depending on the location of the tumor, which may include: a lump or swelling that does not go away, constipation, numbness, headaches, protrusion of the eye, bleeding from the nose, vagina or rectum. Treatment for rhabdomyosarcoma may be carried out alone or in combination. Today, with the most advance surgical technique, tumor could be removed as much as possible. Meanwhile, chemotherapy, radiation therapy, lumbar puncture or/and autologous bone marrow transplant can also be very helpful to get good clinical therapeutic effect.

Leiomyosarcomas TOP

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Overview

Leiomyosarcoma is a common type of soft tissue sarcoma to develop in adults, especially women, and it starts from smooth muscle cell, grows in muscle tissue including muscles in the skin and organs, with abdomen as the most common site. The disease itsself is a very rare, but very treatable cancer, with 80% success rate if the tumor is completely removed. Most people with this disease are older than 50, but children with AIDS are at a risk of developing leiomyosarcoma. People still don’t know the exact causes of leiomyosarcoma, however, it may arise in an area that has previously been exposed to radiation for treating another type of cancer. But the develpoment process usually takes more than 10 years after the radiotherapy treatment.

Signs, symptoms and treatments

Leiomyosarcoma often does not show any symtoms until it is diagnosed after a person develops symtoms, such as a lump or swelling, abdominal pain, weight loss, nausea and vomiting, bleeding from the vagina. The treatments for leiomyosarcoma include surgical excision with or without radiation, and occasionally chemotherapy, depending on the site, size and grade of the tumor, and the extent of its spread. Patient's age, medical history, and general health would also be taken into account to achieve the best outcome.

Fibroblastic sarcomas TOP

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Overview

Fibrosarcomas are bland appearing firm white tumors, which originate in the connective tissue found at the ends of bones of the arms or legs. It can spread to other surrounding soft tissues, such as muscles, tendons, joint tissue, blood vessels, joint tissue and nerves. Fibrosarcoma could be classified into two forms, the first form is called infantile or congenital fibrosarcoma, it’s the most common soft tissue sarcoma diagnosed in babies within one year old. It usually shows a low growth rate and tends to be more benign compared with fibrosarcoma found in older children. While the other form, the adult form, is more aggressive, which can occur in older children and in adolescents within the age ranging from 10 to 15. Like other soft tissue tumors, people still don’t know the exact cause of fibrosarcoma, but some research indicates the genetic alterations may play a role.

Signs, symptoms and treatments

The most common symptoms of fibrosarcomas include a painless or tender mass in an extremity or trunk, pain or soreness, limping or loss of range of motion. However, each patient may experience different symptoms depending on the size, location and stage of disease. Treatment for this kind of sarcoma mainly focuses on treating the primary tumor, and excision surgery is still to be the only curative treatment for this purpose. Radiation is often used when the tumor size is bigger than 5 cm in diameter. Meanwhile, the chemotherapy post surgery remains a controversial topic.

Liposarcomas TOP

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Overview

Liposarcoma is a kind of malignant connective tissue tumour which resembles different stages druing the differentiation process of fat tissue. It usually arises in the abdominal cavity or extremities, such as the thigh or upper arm, but it can also originate in other places in the body. Liposarcoma does not usually spread to other site from its local location. The disease itself is relatively rare, and only about 2,000 people between the ages of 50 and 65 are diagnosed with liposarcoma each year in the United States. Although it has been linked to genetics and inherited diseases, the exact cause is still unknown. A few factors like certain genetic syndromes, a damaged lymph system, exposure to radiation and to some chemicals, may increase the risk.

Signs, symptoms and treatments

Normally, people show no symptoms when they’re diagnosed with a liposarcoma. In some cases, a visible lump develops under the skin, however, this usually isn’t painful at the initial stage. The certain clear warning signs include a painful swelling or a new lump with numbness around it, blood in the patient’s vomit or stool, pain or cramping feeling in abdomen. The most typical treatment for a liposarcoma is surgical excision of the tumor. Usually, radiation or chemotherapy, or combination therapy will be performed before or follow surgery, so as to kill cancer cells in any surrounding tissues.

Synovial sarcomas TOP

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Overview

Synovial sarcoma is a very rare soft tissue sarcoma with a morbidity of 1 to 3 per million and is diagnosed more often in people younger than 30. The cancerous tumor usually arises from soft tissues near the knee or other joints, mainly in the four limbs and can spread to other areas of the body, like the kidney and lung, especially the lymph nodes. People still do not known what kinds of cells this disease originates from. The reason causes synovial sarcoma is unclear, but researches have linked it to genetics.

Signs, symptoms and treatments

Synovial sarcoma tumor is usually to develop with a low growth rate, and people may not notice it germination for a long time until it causes signs and symptoms like moving problems near the affected areas. In more serious situation, patient feels pain if the tumor invaded site has lots of nerves around. Generally, surgery can remove small size tumor, while a combination of surgery, radiation therapy and/or chemotherapy will be carried out if the synovial sarcoma has develop into a serious situation.

Vascular sarcomas TOP

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Overview

Vascular sarcoma is a type of sarcoma that develops in the lining of blood vessels. Normally, the disease can be classified into three subtypes: hemangioendothelioma, kaposi sarcoma, angiosarcoma. Vascular sarcoma is usually diagnosed in adults versus children. It can develop from anywhere in the body as a result of its nature, and spread to other parts of the body including stomach, intestines or lymph nodes which cause the dysfunction in lymphatic system. Up to now, the only subtype with a certain known cause is kaposi sarcoma, which is resulted from the human herpesvirus 8 infection. While for other subtypes, people refer high doses of radiation as the most possible risk factor, except some potential genetic reasons.

Signs, symptoms and treatments

Symptoms often present at the advanced stage of the disease, such as a painless lump or swelling under the skin or in the soft tissue area, and sometimes gastrointestinal bleeding. Doctors perform the treatment plan according to the aggressive varieties of this cancer, with surgery to be the mainstay. Radiation therapy may also be done before and/or after the operation. Additionally, chemotherapy remains a useful treatment in addition.

MPNST TOP

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Overview

MPNST represent a group of highly heterogeneous human malignancies which is similar to benign soft tissue tumors such as neurofibromas and schwannomas. The disease can arise from multiple cell types besides the peripheral nerves or the cells associated with the nerve sheath, with the sciatic nerve, brachial plexus, and sarcal plexus as its most common sites. There’re very rare cases that more than one heterogeneous components exsist in one patient. The patients with a history of radiation exposure always have a higher incidence of this disease, meanwhile NF1, p53, p16 genes are shown to play some important roles in the development of MPNST.

Signs, symptoms and treatments

The most common symptom of MPNST is pain, dizzyness with/without loss of balance, painless peripheral edema and some neurological symptoms. Followed by necessary radiation therapy and/or chemotherapy, surgery is first carried out to remove the tumor along with the surrounding tissue. However, it is hard to avoid the side effects resulted from chemotherapy.

GIST TOP

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Overview

GIST is a relatively rare type of cancer. It originates in the "pacemakers" cells or named the interstitial cells of Cajal (ICCs) which locate in the wall of the GI tract. Most GIST tumors start from the stomach, but they may occur anywhere along the digestive tract from the esophagus, small intestine, rectum, colon, to the anus. More than half of all GIST arises in the stomach, while about one fourth develops in the small intestine. GIST is usually diagnosed in people older than 50, and slightly more cases in men versus women. Researches reveal that most GIST patients have a mutated c-kit gene, but the exact reason that the mutation causes this disease is still not completely clear.

Signs, symptoms and treatments

Many GIST patients with small tumor display no symptom, while pain or discomfort is usually to be the representative symptom on patient with tumor in larger size and/or at aggressive stage. Other symptoms such as vomiting, diarrhea, fatigue, loss of appetite, vomiting of blood and weight loss are also common in clinical reports. The primary option for treating early-stage GIST is still surgery, however, the radiation therapy can’t show a satisfied prognosis. Therefore, unlike other common digestive tract cancers, GIST requires a more specially individualized treatment programme.