Extremity(limb) Sarcoma

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Soft tissue sarcomas are a diverse group of neoplasms that arise in the connective tissues throughout the body. They account for approximately 1% of adult malignancies and 7% to 15% of pediatric malignancies. About 50% to 60% of sarcomas occur in the extremities, and although they are rare, they are responsible for more deaths than testicular cancer, Hodgkin’s disease, and thyroid cancer combined. These tumors are notorious for recurring and metastasizing—often with devastating results—despite apparently complete resection.

Soft tissue sarcomas represent a rare heterogeneous group of mesenchymal tumors that occur predominantly in adults. The group includes a wide variety of histological subtypes with leiomyosarcoma and liposarcoma being the most common subtypes. Most common location includes limbs followed by abdomen and thorax. This chapter describes the practical aspects, including clinical examination, workup, and treatment of soft tissue sarcomas. Important practical points in brachytherapy planning of soft tissue sarcoma are described in the brachytherapy session.

Symptoms

The symptoms of sarcomas vary. For example, in their early stages, some sarcomas may not cause noticeable symptoms. Sarcomas may appear as a painless lump under the skin. Other sarcomas may form in the abdomen, and may not cause symptoms until they grow very large and press on an organ.

Other sarcomas can present as long-lasting bone pain or swelling in an arm or leg that gets worse at night, or decreased mobility.

Sarcoma symptoms that should be investigated are masses (growths) that grow larger, painless masses that have become painful or masses larger than a golf ball (around five centimeters).

In the case of children, a child who has bone pain that does not get better on its own, and that did not occur with an injury, should have an imaging test to investigate.

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