What Are Soft Tissue Sarcomas?
A soft tissue sarcoma is a type of cancer that initiates in the soft tissues or those surrounding, supporting, and connecting other body structures. Soft tissues mainly include muscles, fat, blood vessels, linings of the joints, and tendons. In addition, sarcomas can also occur in the area behind the abdominal cavity (retroperitoneal space). Cancer is a condition wherein the body cells show uncontrolled growth. It can initiate in any body part, and any cell can become cancerous. Though several different types of soft tissue tumors exist, not all of them are cancerous. Some are benign (non-cancerous), whereas others are malignant (cancerous). Some tissues are between the two categories; hence they are known as intermediate soft tissue tumors. The term sarcoma implies that the tumor is malignant. Though chemotherapy and radiotherapy can be done for soft tissue sarcomas, surgical removal is most commonly done depending on the location, aggressiveness, and type of the tumor.
What Are Some of the Risk Factors for Soft Tissue Sarcomas?
Risk factors are those that alter the chances of acquiring the disease. Different cancers are associated with different risk factors. For instance, people with prolonged exposure to direct sunlight are at a higher risk of developing skin cancer. Some of the risk factors for soft tissue sarcomas are listed below:
- Radiation Exposure - Though radiation exposure accounts for five percent of soft tissue sarcomas, the patients might develop sarcomas when treated with radiation for other cancers. The average time elapsed between the radiation procedure and sarcoma diagnosis is approximately ten years.
- Family History - People with a history of soft tissue sarcoma or other types of cancer are at a higher risk of developing the same.
- Damage to the Lymphatic System - Lymph is an important body fluid that comprises immune system cells. When these lymph nodes get damaged due to medical conditions or radiotherapy, the fluid present in the lymph vessels can accumulate, resulting in swelling or tumors.
- Chemicals - Exposure to chemicals like vinyl chloride is one of the major risk factors for the presence of sarcomas in the liver. In addition, exposure to arsenic, dioxide, and herbicides at high doses can increase the risk of cancer.
How Are Soft Tissue Sarcomas Diagnosed?
Diagnostic procedures aim to detect the grades or stages of cancer. In addition, they help the doctor know the extent of the cancer. Some of the diagnostic procedures are listed below:
- Physical Examination - The doctor examines the patient to check the signs and symptoms of cancer, like the presence of lumps or other unusual symptoms.
- Complete Blood Count (CBC) - It is a diagnostic procedure wherein the patient is recommended to undergo a blood test to detect the red blood cells, white blood cells, and hemoglobin levels in the blood.
- Computed Tomography (CT) Scan - CT scan is a simple imaging procedure wherein the patient is laid flat on a table, which moves into a cylindrical device. The X-rays are taken in this device. The images obtained help the doctor diagnose the exact location of sarcomas.
- Magnetic Resonance Imaging (MRI) - An MRI scan is a simple diagnostic procedure that allows the doctor to have three-dimensional access to the nearby organs and other internal structures. The most significant advantage of the procedure is that it helps determine the exact location of a sarcoma.
Which Surgeries Can Be Done for Soft Tissue Sarcoma Reconstruction?
The primary treatment method for soft tissue sarcoma is surgery. The doctor needs to remove the tumor completely to prevent its recurrence. In addition, small amounts of healthy tissues are also removed along with the tumor. As soft tissue sarcomas can initiate in any body part, the surgery depends on the tumor type, location, and extent. Some people get cured through chemotherapy or radiotherapy alone, while others get surgery. However, an expert surgeon must always do the surgery because it requires careful planning and a thorough anatomy evaluation. The different forms of surgery for soft tissue sarcomas are listed below:
- Limb-Sparing surgery - Limb-sparing surgery or limb salvage surgery is a type of wide local excision. People who undergo this surgery usually have a higher grade or large-size tumor. This surgery aims to eliminate the tumor and saves one from the trauma of removal of critical nerves and blood vessels. Studies report that 90 to 95 percent of tumors can be removed without amputation. Limb-sparing surgery can often be accompanied by chemotherapy or radiotherapy to shrink the tumor.
- Amputation - Amputation can sometimes be used as a primary treatment method for sarcomas in the extremities. However, amputation is usually preferred only in those cases where the tumor affects the surrounding arteries and nerves. Sometimes the tumor can be removed without amputation, but the patient might have limited functions. Amputation benefits patients who plan to have prosthetic limbs later to restore functionality.
- Laparoscopic Surgery - It is a minimally invasive procedure that is used for the treatment of gastrointestinal tumors. For people having tumors within the chest, thoracoscopic surgery is often used.
- Reconstructive Surgery - Reconstructive surgery is often performed during amputation or limb-sparing surgery. The surgical method depends on the location of the tumor. In addition, the plastic surgeon might obtain tissues or muscles from some body parts and implant them into the space left after tumor removal.
- Plastic Surgery for Sarcoma - Plastic surgery is often required to repair the area. It is usually done at the time of sarcoma removal. However, one needs to note that the operation is unique to the patient and depends on the location of the sarcoma. The different surgical approaches are listed below:
- Skin Grafts - During this procedure, the doctor obtains a strip of skin from one part of the body and stitches it into another body part. The area from which the skin is removed is called the donor site. The donor site heals within a few days, whereas the site wherein the tissue is implanted, known as the repair site, will be more delicate.
- Tissue Flaps - Plastic surgery mainly uses a technique known as tissue flap, wherein tissues obtained from different body parts are implanted in the appropriate area.
Conclusion:
As the name suggests, a soft tissue sarcoma affects the soft tissues lining the important body organs. Though sarcomas mainly refer to cancerous lesions, they are not life-threatening and can be treated with surgical intervention. Plastic surgery or reconstructive surgeries are crucial in treating soft tissue sarcomas and restoring the functionality of affected organs.
