Source: Cancer Resource Room
is a pediatric sarcoma?
cancerous tumors that grow from abnormal
cells in connective tissues. Connective
- blood or lymph vessels
Sarcomas are divided in two major groups.
Sarcomas that develop in bones and cartilage
have special names, like Osteosarcoma
and Chondrosarcoma. Sarcomas that develop
in soft tissue (muscle, fat, blood, lymph
vessels, and nerves) are called Soft
Tissue Sarcomas. There are more than
30 different sarcomas. The most common
- malignant fibrous histiocytoma
Sarcomas occur in people of all ages,
in both sexes, and in people who are
otherwise in good health. Sarcomas usually
have no known causes, except high-dose
radiation or genetics. Sarcomas are rare,
with only about 8,700 new cases per year
in the United States. Thus, these tumors
are best evaluated and treated at a cancer
center by sarcoma specialists.
may have a lump they can see or feel.
It is usually a painless lump, but if
it is large or pressing on nearby structures,
like nerves, it can cause pain. A sarcoma
can be seen or felt when it is close
to the surface of the body. If it occurs
deep in the body, it may grow quite large
before being noticed. There are no screening
tests for sarcomas.
Once a mass (or lump) is noticed, a process
of evaluation begins.
The first and most important
part of this process is the history of
the person's illness and a thorough physical
exam. X-rays are taken of the area of
the mass. A CT scan or an MRI (or both)
is done to help understand the size and
nature of the tumor, and its relationship
to the surrounding tissues. A chest X-ray
or chest CT scan is done to see if disease
has spread to the lungs. Blood tests
help evaluate the general health of the
After the preliminary tests
are complete, a method of testing the
tumor tissue is chosen. This is called
a biopsy and can be done in one of several
- Core Needle Biopsy
If the tumor is near the surface of the skin and can be palpated (felt),
this test can be performed in the office by the orthopedic or surgical
oncologist. Local anesthesia will be used. If the tumor is deeper,
this test will be done in the radiology suite by a radiologist. Local
anesthesia and some intravenous sedative medications will be used.
- Incisional or Excisional Biopsy
These biopsies are performed in the office or in the outpatient operating
room. These types of biopsies need to be performed very carefully
to avoid spreading the cancerous cells. Either local or general anesthesia
will be used. In an incisional biopsy, the surgical oncologist
removes a portion of the tumor. In an excisional biopsy,
the surgical oncologist removes the entire tumor with little or no
margin (immediate area around the tumor).
What do the results of a biopsy
mean for the patient?
Two important things are learned
from the biopsy.
- Type of Sarcoma
The pathologist can decide whether or not the tumor is a sarcoma, and
if so, what type it is. The particular type of sarcoma can influence
decisions about the treatment.
- Grade of Tumor
Second, something called the "grade" of the tumor is determined.
Soft tissue sarcomas are graded as either low-grade or high-grade tumors.
Low-grade tumors generally grow slowly and are unlikely to spread to
distant sites. High-grade tumors grow more quickly and have a greater
chance of spreading to distant sites. The most common site of distant
spread is the lungs.
How is the treatment planned?
A number of specialists will
contribute to determining an accurate
diagnosis. Then a treatment plan will
be made. A panel of specialists in sarcoma
treatment should review the results of
all the tests, radiologic studies and
biopsies to create the plan. Each patient
is unique so treatment should be individually
- For small, low -grade tumors, treatment
may involve surgery alone, or surgery
- Large, high-grade tumors may need
a combination of surgery, radiation,
and chemotherapy for adequate treatment.
The necessary surgery, radiation
and chemotherapy differ in extent,
timing, and combination for each
tumor being treated.
Who will be on my treatment team?
The appropriate care of a sarcoma
patient requires the expertise of people
in many specialties. You may have care
provided by the following specialists:
- Medical oncologists
- Orthopedic and general surgeons specializing
- Radiation oncologists
- Oncology nurses
- Social workers, psychiatrists or
- Physical and occupational therapists
To find out who
treats sarcomas at Massachsuetts
General Hospital Cancer Center >>>
& Education Programs
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family. We offer a variety of cancer support services to help patients and
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