Soft tissue tumors can develop in every type of soft tissue in the body, including nerves, fat, muscle, and blood vessels. They can be malignant (cancerous) or benign. Malignant tumors are known as sarcomas.
Sarcomas can occur in almost any organ, including the lungs, heart, gastrointestinal tract, liver, kidney and the extremities.
About 60% of soft tissue sarcomas occur in the legs and arms. They can also occur in the trunk, abdomen, and head and neck region.
Note: Tumors that develop in bones and cartilage are discussed under Bone Tumors.
Review the tabs at top of this page for information on soft tissue sarcoma types, diagnosis, and treatment.
Often, soft tissue sarcomas present no symptoms in their early stages.
When sarcomas develop on the arms or legs, they can cause a lump that grows over a period of time. It may or may not be painful. A sarcoma can cause pain as it grows and exerts pressure on nerves and muscles.
Other symptoms can include worsening abdominal pain and blood in your stool or vomit.
If your physician suspects a soft tissue sarcoma, he or she will order a biopsy so tissue samples can be examined by a pathologist under a microscope. The type of biopsy will be based on the size and location of the tumor. Biopsy types include:
- Incisional biopsy: The removal of part of a lump or a sample of tissue
- Core biopsy: The removal of tissue using a wide needle
The stage of a cancer describes its size and whether it has spread beyond its original area of the body. In sarcoma staging, doctors also evaluate the appearance of the tumor under the microscope and judge how fast the cancer seems to be growing.
- IA: The cancer cells look either very much like normal cells or somewhat different from normal. The cancer is less than five centimeters (about two inches) in size, and has not spread to lymph nodes or other parts of the body. It may be near the surface or deep.
- IB: The cancer cells look either very much like or somewhat different from normal cells. The cancer is near the surface and more than five centimeters in size, but it has not spread to lymph nodes or other parts of the body.
- IIA: The cancer cells look either very much like normal cells or somewhat different from normal. The cancer is deep and more than five centimeters in size, but it has not spread to lymph nodes or other parts of the body.
- IIB: The cancer cells look very different from normal cells. The cancer is either near the surface or deep and is less than five centimeters in size, but it has not spread to lymph nodes or other parts of the body.
- IIC: The cancer cells look very different from normal cells, the cancer is near the surface, is more than five centimeters in size, but it has not spread to lymph nodes or other parts of the body.
- III: The cancer cells look very different from normal cells. The cancer is deep and is more than five centimeters in size, but it has not spread to lymph nodes or other parts of the body.
- IV: The cancer may have spread to lymph nodes in the area or may have spread to other parts of the body, such as the lungs, head, or neck.
- Recurrent: The cancer has returned (recurred) after being treated. It may recur in the tissues where it originally started, or elsewhere.
Treatment options for soft tissue sarcomas include surgery, radiation therapy, and chemotherapy.
At UC San Diego Health, our oncology team will determine the best treatment or combination of treatments you, depending on the type and stage of your sarcomas.
The primary treatment for most soft tissue sarcomas is surgery to remove the tumor. Depending on the type and extent of the tumor, surgical options include:
Mohs microsurgery: During this procedure, the tumor is cut from the skin in thin layers. During surgery, the edges of the tumor and each layer of tumor removed are viewed through a microscope to check for cancer cells. Layers continue to be removed until no more cancer cells are seen.
Wide local excision: Surgical removal of the tumor (excision) along with some normal tissue around it.
Limb-sparing surgery: In the past, treatment for primary malignant soft tissue sarcomas of the extremities was often amputation of the affected limb. However, advances in surgical techniques (including minimally invasive procedures), as well as chemotherapy and radiation treatments have resulted in new limb-sparing surgical procedures. The goal of limb-sparing surgery is the complete removal of the tumor with preservation of limb and function.
At UC San Diego Health, the orthopedic oncology team has experience and expertise in these limb-sparing surgical techniques. In cases where bone tissue needs to be removed, reconstructive surgery can be performed to restore mobility and improve function.
Lymphadenectomy: Surgical removal of the lymph nodes that contain cancer.
This treatment with high-dose x-rays can be used before surgery to shrink soft tissue tumors and make them easier to remove. It's sometimes used after surgery to kill any cancer cells that may have been left behind.
We use the advanced technology known as Intensity Modulated Radiation Therapy, or IMRT, to precisely target the tumor and reduce damage to surrounding healthy tissues.
Chemotherapy, the use of anti-cancer medications, may be used to shrink tumors and make the tumor more accessible for removal by surgery or radiation treatment. Chemotherapy before surgery is called neoadjuvant treatment.
Chemotherapy that follows radiation or surgery is known as adjuvant treatment, and is used to destroy any remaining malignant cells.