Soft Tissue Sarcomas

Different kinds and places

There are more than 80 kinds, including liposarcoma (in the belly and limbs), leiomyosarcoma (in smooth muscle), synovial sarcoma (in joints and young adults), and rhabdomyosarcoma (in skeletal muscle and youngsters). Fifty percent of cases occur in the extremities, while the trunk and head-neck are less common. Undifferentiated pleomorphic sarcoma, which is a high-grade type, affects the legs.

Clinical Characteristics

Present as hard, painless, deep-seated masses greater than 5 cm, with progressive growth. Pain indicates nerve compression; advanced cases exhibit oedema, tiredness, and metastasis, affecting the lungs in 20-30% of instances. When growth flags like ABCDE go up quickly, it means that something needs to be done right away.

Diagnosis and Staging

MRI/CT shows how far the disease has spread, while core biopsy shows the grade and subtype using IHC/molecular markers (for example, t(12;16) in myxoid liposarcoma). PET staging looks at nodes and metastases, and a multidisciplinary assessment helps with the AJCC TNM classification.

How to Treat

Wide local excision with 2 cm margins is the first choice, and limb salvage is better than amputation (90% possible). For high-risk patients, neoadjuvant/adjuvant chemotherapy (doxorubicin/ifosfamide) is used. Radiation therapy decreases tumours and lowers their chances of coming back by 20%. Targeted therapy (pazopanib) is best for advanced disease; 60%–80% of those with localised disease survive for 5 years, but only 20% of people with metastatic disease do.