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A sarcoma is a type of cancer that develops from certain
tissues, such as bone or muscle. There are 2 main types of sarcoma:
osteosarcoma, which develops from bone, and soft tissue sarcomas. Soft
tissue sarcomas can develop from soft tissues such as fat, muscle,
nerves, fibrous tissues, blood vessels, or deep skin tissues. They can
be found in any part of the body. Most of them develop in the arms or
legs. They can also be found in the trunk, head and neck area, internal
organs, and the area in back of the abdominal cavity (known as the retroperitoneum).
Sarcomas are not common tumors, and most cancers are the type of tumors
called carcinomas.
There are many types of soft tissue tumors, and not all of
them are cancerous. When a tumor is not cancerous, it is called benign. When the
term sarcoma appears in the name of a disease, it means the tumor is
malignant (cancer). There are about 50 different types of soft tissue
sarcomas (not all are listed here).
This document concentrates on soft tissue sarcomas in adults.
Sarcomas occurring in bone, such as osteosarcomas
and Ewing
tumors are discussed in separate documents. Rhabdomyosarcoma,
the most common type of soft tissue sarcoma seen in children, is also
discussed in another document.
Tumors of fat tissue
Benign fat tissue tumors
Lipomas are benign tumors of fat tissue. They are the most
common benign soft tissue tumor. Most are found under the skin, but
they can develop anywhere in the body.
Lipoblastomas are benign fat tumors that occur in infants and
young children.
Hibernomas, like lipomas, are also benign fat tissue tumors.
They are much less common than lipomas.
Cancerous fat tissue tumors
Liposarcomas are malignant tumors of fat tissue. They can
develop anywhere in the body, but they most often develop in the thigh,
behind the knee, and inside the back of the abdomen. They occur mostly
in adults between 50 and 65 years old.
Tumors of muscle tissue
There are 2 types of muscle: smooth and skeletal.
Smooth muscle is found in internal organs such as stomach,
intestines, blood vessels, or uterus (womb) and causes them to
contract. These muscles are involuntary -- that is, we don't control
their movement.
Skeletal muscle is sometimes called striated (because
stripes can be seen inside the cells under the microscope). This is the
type of muscle that lets us move our arms and legs and other body parts
when we want them to move -- that is, voluntary movement.
Benign muscle tumors
Leiomyomas are benign tumors of smooth muscle (or involuntary
muscle). Since leiomyomas can start from the walls of blood vessels,
they can develop almost anywhere in the body. These tumors also can
start in the walls of the intestine. Although they can be found in both
men and women, the most common place to find a leiomyoma is in the
walls of the uterus. They are often called fibroids.
Rhabdomyomas are rare benign tumors of skeletal muscle.
Malignant muscle tumors
Leiomyosarcomas are malignant tumors of smooth muscle. Like
leiomyomas, they can grow almost anywhere in the body. They are most
often found in the retroperitoneum (area in back of the abdominal
cavity), the internal organs, and blood vessels. These tumors are less
often found in the deep soft tissues of the legs or arms. They tend to
occur in adults, particularly the elderly. Leiomyosarcomas of the
uterus are discussed in detail in our document, Uterine Sarcomas.
Rhabdomyosarcomas are malignant tumors of skeletal muscle.
These tumors commonly grow in the arms or legs, but they can also begin
in the head and neck area and in reproductive and urinary organs such
as the vagina or bladder. Children are affected much more often than
adults. For more information, see our document, Rhabdomyosarcoma.
Tumors of peripheral nerve tissue
The brain and spinal cord are parts of the central nervous
system. The nerves that run throughout the body are part of the
peripheral nervous system. Tumors can start in these peripheral nerves.
Benign nerve tumors
Neurofibromas, schwannomas (neurilemomas), and neuromas are
all benign tumors of nerves. These tumors can occur almost anywhere in
the body. Neurofibromas are very common in people with an inherited
condition called neurofibromatosis (also called von Recklinghausen
disease). Sometimes neurofibromas of very large nerves (such as those
in the upper arms or neck) can become malignant.
Malignant nerve tumors
Neurofibrosarcomas, malignant schwannomas, and neurogenic
sarcomas are malignant tumors of the cells that surround a nerve. These
are also called malignant
peripheral nerve sheath tumors.
Gastrointestinal stromal tumors (GIST) are a type of sarcoma
that develops in the digestive tract. They start in the cells that
control the muscles lining the stomach and intestine. These muscles
propel food through the digestive tract. GIST is not discussed further
in this document, but is covered in detail in our document, Gastrointestinal Stromal Tumors.
Tumors of joint tissue
Our joints are surrounded by a capsule made of a tough tissue
called synovium.
This tissue produces a fluid that lubricates the joint surfaces so that
they move smoothly. Tumors of joints can start in the synovium.
Benign joint tumors
Nodular tenosynovitis is a benign tumor of joint tissue. It is
most common in the hands and is more common in women than in men.
Malignant joint tumors
Synovial sarcoma is a malignant tumor of the tissue around
joints (the synovium). The most common locations are the knee and
ankle. Other sites are the shoulder and hip. This tumor is more common
in children and young adults, but it can occur in older people.
Tumors of blood and lymph vessels
Benign vessel tumors
Hemangiomas are benign tumors of blood vessels. They are
rather common and can affect the skin or internal organs. They are
sometimes present at birth, and some disappear without treatment.
Lymphangiomas are benign lymph vessel tumors that are usually
present at birth. Lymph is a type of fluid that circulates in every
tissue of the body, ending up in the venous system. It carries waste
products from tissues and immune system cells.
Glomus tumors are benign tumors that are found around blood
vessels (perivascular). They usually are found under the skin of the
fingers.
Intermediate vessel tumors
Hemangiopericytoma is another tumor of perivascular tissue.
This tumor can be either benign or malignant. It most often develops in
the legs, pelvis, and retroperitoneum (the back of the abdominal
cavity). It is most common in adults. This type of tumor
doesn’t often spread to distant sites, but it does tend to
come back in or near the same place that it started, even if it was
removed completely at surgery.
Hemangioendothelioma is a blood vessel tumor that is
considered a low-grade cancer (meaning it grows slowly and is slow to
spread). It does grow into nearby tissues and sometimes can spread to
distant parts of the body (metastasize). It may develop in soft tissues
or in internal organs, such as the liver or lungs.
Malignant vessel tumors
Angiosarcomas are malignant tumors that can develop either
from blood vessels (hemangiosarcomas) or from lymph vessels
(lymphangiosarcomas). These tumors are linked to radiation exposure -
they sometimes develop in a part of the body that has been treated with
radiation. Angiosarcomas are sometimes seen in the breast after
radiation therapy for breast cancer, and in limbs that are chronically
swollen because lymph circulation is blocked (lymphedema)..
Kaposi sarcoma is a cancer formed by cells similar to those
lining blood or lymph vessels. In the past, Kaposi sarcoma was an
uncommon cancer mostly seen in older people with no apparent immune
system problems. But it is now seen more often in people with
suppressed immune systems (from HIV infection and in organ transplant
patients). It is not discussed further in this document, but is covered
in detail in our document, Kaposi Sarcoma.
Tumors of fibrous tissue
Fibrous tissue forms tendons and ligaments and covers bones as
well as other organs in the body.
Benign fibrous tumors
These include:
- fibromas,
- elastofibromas,
- superficial fibromatosis
- fibrous histiocytomas
Intermediate fibrous tumors
Fibromatosis is the name given to fibrous tissue tumor with
features in between fibrosarcoma and benign tumors such as fibromas and
superficial fibromatosis. They tend to grow slowly but, often,
steadily. These tumors are also called desmoid tumors, as
well as the more scientific name musculoaponeurotic
fibromatosis. They do not spread to distant sites, but
they do cause problems by growing into nearby tissues. They can
sometimes be fatal. Some doctors consider these to be a type of
low-grade fibrosarcoma; but others believe they are a unique type of
fibrous tissue tumors. Certain hormones, particularly estrogen, make
some desmoid tumors grow. Anti-estrogen drugs are sometimes useful in
treating desmoids that cannot be completely removed by surgery.
Dermatofibrosarcoma protuberans (DFSP) is a slow-growing
cancer of the fibrous tissue beneath the skin, usually in the trunk or
limbs. It grows into nearby tissues but rarely spreads to distant
sites.
Malignant fibrous tumors
Fibrosarcoma is cancer of fibrous tissue. It usually affects
the legs, arms, or trunk. It is most common in people between the ages
of 20 and 60, but can occur at any age, even in infancy.
Tumors of uncertain tissue type
By looking at tumor tissue under the microscope and doing
other tests, doctors can usually find similarities between most
sarcomas and certain types of normal soft tissues. However, some
sarcomas have not been linked to a specific type of normal soft tissue.
Benign uncertain tissue type tumors
Myxoma is a benign tumor that usually is located in muscles
but does not develop from muscle cells. The cells of a myxoma produce
mucus-like material, a feature that distinguishes this tumor. It almost
always occurs in adults.
Granular cell tumors are usually benign tumors in adults that
occur often in the tongue but can be found almost anywhere in the body.
Malignant uncertain tissue type tumors
Malignant mesenchymoma is a rare type of sarcoma that contains
some areas showing features of fibrosarcoma and other areas with
features of at least 2 other types of sarcoma.
Alveolar soft-part sarcoma is a rare cancer that mostly
affects young adults. These tumors most commonly occur in the legs.
Epithelioid sarcoma most often develops in tissues under the
skin of the hands, forearms, feet, or lower legs. Adolescents and young
adults are often affected.
Clear cell sarcoma is a rare cancer that often develops in
tendons of the arms or legs. Under the microscope, it shares some
features with malignant melanoma, a type of cancer that develops from
pigment-producing skin cells. How cancers with these features develop
in parts of the body other than the skin is not known.
Desmoplastic small round cell tumor is a rare sarcoma of
adolescents and young adults, found most often in the abdomen. Its name
means that it is formed by small, round cancer cells surrounded by
scar-like tissue.
Pleomorphic undifferentiated sarcoma, also known as malignant
fibrous histiocytoma (MFH), is most often found in the arms or legs.
Less often, it can develop inside the back of the abdomen. This sarcoma
is most common in older adults. Although it mostly tends to grow
locally, it can spread to distant sites.
Spindle cell tumor and spindle cell sarcoma are named based on
the long, narrow appearance of the cells under the microscope). A
spindle cell tumor is a tumor with cells that look like these. Spindle
cell tumor is not a specific diagnosis or a specific type of cancer.
The tumor may be a sarcoma, or it can be sarcomatoid --
meaning another type of tumor (such as a carcinoma) that looks like a
sarcoma under the microscope.
Other types of sarcoma
There are other types of tumors called soft tissue sarcomas;
however, these are all quite rare.
Tumor-like conditions of soft tissue
Some conditions of soft tissues are caused by inflammation or
injury and can form a mass that looks like a soft tissue tumor. Unlike
a true tumor, they do not come from a single abnormal cell, they have
limited capacity to grow or spread to nearby tissues, and never spread
through the bloodstream or lymph system. Examples include nodular fasciitis
and myositis ossificans,
which involve tissues under the skin and muscle tissues, respectively.
Last Medical Review: 03/03/2009 Last Revised: 05/14/2009
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