Lung sarcoma - symptoms, treatment and survival. Are you interested in modern treatment in Israel? Relationship between lung sarcoma and asthma
Malignant soft tissue tumors account for only 1-2% in the structure of oncological diseases. They are most common in children and the elderly. According to various sources, leiomyosarcoma accounts for 15 to 20% of patients.
Leiomyosarcoma originates from muscle tissue. As it grows, nearby bone structures and internal organs may become involved in the process. In this case, the tumor tends to spread through the intermuscular spaces far beyond the initial focus. Leiomyosarcoma is found in lower limbs(50-60% of cases), upper limbs(11-30%) and torso (10-20%).
Features of leiomyosarcoma:
- these tumors are quite aggressive, but at first they are asymptomatic;
- occur predominantly in the lower extremities;
- grow infiltratively, multicentrically, in the thickness of soft tissues. A pseudocapsule is formed around them, which has no clear boundaries;
- as the volume of the tumor increases, it begins to put pressure on the nerves and blood vessels, thereby causing swelling and pain;
- they are prone to repeated relapses after treatment.
What causes leiomysarcoma?
For soft tissue sarcomas, Trabectedin and Pazopanib, which are classified as targeted drugs, began to be used. It is also worth noting the positive results from the drugs Sorafenib and Imatinib.
Since the symptoms of leiomyosarcoma in initial stages very scanty, the disease is often diagnosed in an advanced stage. Delaying treatment significantly reduces the chances of long-term survival. Very few cases of uterine leiomyosarcoma have been described, so there is no uniform standard of treatment for this pathology. Such neoplasms are treated in a similar way to sarcoma: the uterus, fallopian tube and ovaries are removed.
Radiation and chemotherapy for uterine leiomyosarcoma do not have a significant effect on patient survival. They can be used for inoperable patients, as well as in advanced cases to reduce the risk of metastasis.
Metastasis and recurrence of leiomysarcoma
Muscle sarcomas are characterized by early metastasis. Distant lesions were found in 25-35% of patients at the time of diagnosis. Metastases in leiomyosarcoma often spread hematogenously to the lungs and bones. In 10%, metastasis through the lymphatic system is observed, and this is considered an unfavorable prognostic factor. The period of occurrence of distant foci of the disease depends on the histological type of tumor and the degree of malignancy. For isolated metastases in the lungs (if there is no damage to other distant organs), surgery is performed to remove them. This can be segmental or marginal resection, lobectomy. Tumors in the lymph nodes can also be operated on. Statistics show that after surgical removal of metastases, the median survival rate increases by 2 times, compared with patients who did not undergo such treatment. As an alternative or in addition to surgical method Chemoperfusion of the lungs with Doxorubicin or Cisplatin can be used.
Adjuvant chemotherapy is also indicated for the treatment of metastases. The recurrence rate of muscle tissue sarcomas is 50%. Recurrence of leiomyosarcoma occurs in the thickness of the postoperative scar or next to it. A secondary tumor can be not only single, but also multiple. They are treated in the same ways as primary sarcomas, but, if possible, more radical approaches are used. They perform en bloc resection or amputation, change chemotherapy drugs, increase their doses, etc. For second line chemotherapy effective drugs are considered and . The timing of relapse cannot be predicted. This could happen within a couple of months or many years later. The likelihood of disease progression increases if the treatment was not radical. Experts say that relapse itself has virtually no effect on survival prognosis. Indicators depend on the location, size and grade of malignancy of the secondary tumor.
Life prognosis for leiomysarcoma
Leiomyosarcoma has a slightly lower prognosis than other soft tissue tumors: the 5-year overall survival rate does not exceed 71%, and the 5-year disease-free survival rate is about 80%.
Poor prognostic factors include:
- tumor size more than 5 cm;
- more than 50% necrosis;
- more than 20 mitoses per 10 fields of view;
- high degree malignancy;
- relapses.
The histological type of tumor also plays some role. It has been noted that pleomorphic leiomyosarcoma has the lowest survival rate. For patients with stage 4, the median survival is 8-20 months.
Prevention of cancer
The reason for a late diagnosis is a late visit to a specialist, as well as mistakes by the doctor himself. Therefore, people and doctors need to be more alert about cancer. In order to detect oncology on time, it is important for women to undergo an annual gynecological examination.
Leiomyosarcoma in people with weakened immune systems occurs due to the body’s inability to protect itself from pathological cancer cells, therefore it is necessary to strengthen one’s own defenses through fortified nutrition, taking special drugs etc. Also, prevention of leiomyosarcoma should include quality treatment pre-tumor inflammatory diseases. It is equally important to avoid injury.
Informative video:
The human body is subjected to tests of the external world and confrontation with it. Any ailment depends on the immune system, but there are diseases that manage not only to survive, but also to live at the expense of the body.
Let's consider a dangerous disease like sarcoma. It is worth noting that this is not a type of cancer, but both diseases have similar symptoms and developmental features.
Sarcoma is a disease that is accompanied by the appearance of a malignant tumor, which can be treated, if successfully removed, using expensive equipment, using unique, modern methods, in foreign clinics that are leading in the field of cancer treatment.
A malignant tumor poses a danger to the human body; uncontrolled harmful cells develop in it, with chaotic and rapid development, which inhibit and stop the division of beneficial cells.
Sarcomas are a type of malignant tumors, as a result of active division of connective tissues, lymphatic and blood vessels.
Sarcoma is not cancer, but a disease with very similar symptoms, the process of development of sarcoma is faster in time, compared to cancer diseases. Compared to cancer, sarcomas are not attached to organs (their epithelial cells); in turn, the development of the disease (tumor formation) occurs in the epithelial cells of internal organs or from the covering epithelium of external organs.
The similarity of symptoms with cancer is that sarcoma has following features- infiltrating growth (accumulation of cell elements mixed with blood and lymph and an increase in volume with increased density) destroying neighboring tissues, frequent relapses are likely after tumor removal.
With sarcoma, the tumor develops at an explosive rate, especially in children's body, is accompanied by constant relapses, and ranks second after cancer in terms of number deaths, in the category - malignant diseases (tumors).
According to the data medical statistics- sarcomas are rare, 1% of cases in medical practice among malignant tumors.
The lungs are an important human organ, which is an integral part of the human body’s respiratory system, providing oxygen to all tissues, organs, blood, and without air the human body is not able to survive.
Lung sarcoma is a malignant pathological tumor in the connective tissue of this organ. It is dangerous due to its specific rapid development and metastasis to other organs and systems of the human body.
This insidious disease due to the specifics of the flow and real danger for the human body. The tumor can progress in size and occupy a large area of the lung, and in difficult cases complete defeat is possible.
Degree of development of sarcomas
- Low-grade tumors with slow cell division.
- Highly malignant - cells divide quickly.
The causes of the disease are not fully understood by medicine, but the factors are known:
- Bad habits, especially smoking.
- Genetic predisposition.
- Exposure to radio rays.
- Polluted environment.
Symptoms of sarcoma
The clinical picture is influenced by the location of the tumor and the characteristics of the original cells. Most sarcomas are characterized by an actively developing (increasing in size) tumor.
For example, with bone sarcoma, pain in the area of the affected bone makes itself felt, especially pronounced at night.
Lung sarcoma symptoms: at the initial stage of development, lung sarcoma will not show any symptoms specific to this disease.
This is a dangerous factor when a disease begins to develop in the body, but it is almost impossible to diagnose. Unlike initial degree, at stage 4 of development, lung sarcoma will show the full intensity of the manifestation of its specific painful symptoms.
Characteristic features:
- High level of fatigue.
- Shortness of breath, even with minimal physical activity.
- As a result of congestion in the lungs, hypertrophy of the atrium and right ventricle occurs.
- Dysphagia, difficulty swallowing.
- Pneumonia, which cannot be cured, in this case.
- Frequent colds.
- Possible nausea, vomiting, dizziness, convulsions, pain in the head.
- The occurrence of metastases in other organs, with accompanying characteristic clinical manifestations of the disease.
When distributed in the body, with high probability may arise systemic disease– Kaposi's sarcoma of the lungs. In this case, defeat occurs lymphatic system and internal organs.
Symptoms of Kaposi's sarcoma:
- Rapid weight loss.
- Frequent fevers.
- Formation of liquid in a thick form.
- Bloody discharge when coughing.
- Shortness of breath.
- Pain in the chest area.
- Difficult, heavy and noisy breathing.
Diagnosis of lung sarcoma
Diagnosis of this disease is a very important step in its treatment, on which the patient’s life expectancy and possible risks depend.
Exclusively experienced specialist able to make the correct diagnosis.
The difficulty of diagnosis lies in the fact that at the initial stage of development the disease does not manifest clinical signs. With manifestation specified symptoms you should go to the hospital.
To determine the disease, the doctor will prescribe the necessary tests and examination, and, based on the body’s research data, a diagnosis will be made and the doctor will be able to recommend treatment.
Treatment of lung sarcoma
Modern medicine uses effective methods to combat sarcoma. Leading cancer clinics, for example in Germany and Israel, are developing their own methods of combating pathology.
In medical practice, there are methods to combat sarcoma:
- Surgical intervention and an effective method of control.
- Chemotherapy, when a person's risk of developing a tumor is greater than the confirmation of his chemotherapy.
- Radiation therapy– the method is not new and effective.
It is important to adhere to a special diet along with treatment to support your body in the fight against the disease. At successful implementation Operations can predict life expectancy; if the lesion is removed, then recovery occurs.
In domestic hospitals they can carry out surgery without latest achievements new technologies, everything depends on the success of the operation.
conclusions
Sarcoma is an insidious and dangerous disease among malignant tumors.
On initial stages of its development, the disease will not make itself known by any signs. Sarcomas are more dangerous than cancer in that they can develop faster, but they are safer in that they can be successfully removed.
When treating this disease, it is important to adhere to a special diet, healthy image life, monitor the health of the body with full responsibility and care.
Leading clinics in Israel and Germany (as well as other countries where medical practice in the fight against oncological diseases) are ready to treat patients with sarcoma and cancer, according to the latest research and achievements medical practice, as well as the development of special effective, proprietary treatment regimens and methods.
Treatment in these foreign clinics is ⏤ expensive, but human life is more valuable.
The outcome of treatment also depends on the stage of development of the disease; in the initial stages, there is a greater chance of surviving after treatment. If suspicious symptoms occur, immediately contact a doctor for qualified help.
After successful diagnosis and passing necessary tests, the doctor will be able to adequately help you with treatment and useful recommendations. Treatment is carried out with the help of surgery, chemotherapy, laser therapy, it is also important to follow the doctor’s recommendations regarding special diet and lifestyle.
We tried to collect all the information useful to you. Get well and take care of yourself!
Lung sarcoma is a rapidly progressing malignant neoplasm that is almost always fatal. The tumor originates from mesenchymal tissue, which is connective and makes up most the body as a whole. Its derivatives are considered to be muscles, cartilage, bones, and nerves. This explains the degree of damage to the lung during the development of sarcoma.
The danger of this disease is that it affects absolutely any age groups people regardless of gender. The younger the patient, the more intensive growth tumors. The prognosis for untimely detected lung sarcoma is extremely unfavorable.
Causes of occurrence, mechanism of development and types
The etiology of the development of lung sarcoma has not yet been accurately established. Predisposing factors to the occurrence of this disease include:
The above factors have a negative impact on respiratory system humans due to the effect on the mucous membrane, however, what is the determining trigger is not known.
In the lungs, most structures are composed of connective tissue, so malignant degeneration cells can be in any of them - bronchi, alveoli, lymph nodes, blood vessels, nerves.
The triggering factor for such a process is unknown. This determines the various morphological forms of lung sarcoma:
Often, several types of neoplasms occur simultaneously in one patient. Therefore, the diagnosis of lung sarcoma is collective and combines various tumors. Carcinosarcoma is an unfavorable option because it combines the degeneration of cells of different layers (mesenchymal and epithelial) of the respiratory tract wall.
Stages of development include the following stages, which form the basis clinical classification lung sarcomas:
- The tumor size is up to 3 cm, there are no metastases.
- Growth of the tumor up to 6 cm with metastasis to the root of the lung.
- The tumor is more than 6 cm, grows into surrounding tissues and affects nearby lymph nodes.
- Formation of various sizes, with metastases to distant tissues and organs.
Depending on whether the disease initially arose in the lungs or was a consequence of metastasis of other tumors, sarcoma is divided into primary and secondary.
Oncologists make a diagnosis based on the extent of the lesion, the volume of formation, the presence of metastasis, and changes in the lymph nodes. This classification is called TNM. In this case, T is the tumor size, N is regional lymph nodes, M is metastases to distant organs and tissues. The location of the sarcoma is also indicated - central or peripheral.
The neoplasm is a massive node, located separately or growing into the surrounding tissue.
New formation of vessels occurs inside it, providing good vascularization (blood supply), and as a result - active growth tumors. Lung sarcoma is prone to metastasis, growing into surrounding tissues and organs. Due to rapid growth, the tumor can affect the entire lung, causing a severe clinical picture.
Symptoms
For a long time lung sarcoma may not be clinically apparent. Upon careful questioning, patients note complaints about:
As the disease progresses, immunity decreases, as a result of which patients often develop pneumonia around the tumor (paracancrosis) and pleurisy (fluid in the pleural cavity).
When sarcoma grows into the pericardial cavity, various symptoms cardiovascular diseases: rhythm disturbances, heart pain, palpitations.
The first signs may be complaints not related to lung damage. This is called paraneoplastic syndrome. In this case, the patient notes pain in the joints, finger deformities, and arthritis.
Diagnostics
Making a diagnosis is complex. Complaints, life history and illness, results of objective and subjective studies are assessed. Patients with suspected lung sarcoma should definitely consult an oncologist or thoracic surgeon.
Due to the absence of clinical manifestations in the early stages of the process, diagnosis is carried out already for large tumors. Secondary lung sarcomas are often found incidentally during routine annual FLG examinations.
The following examinations are prescribed:
IN general analysis blood, a number of nonspecific changes are found: a decrease in the level of hemoglobin and red blood cells, an increase in the number of platelets, an acceleration of ESR.
A survey radiograph allows you to determine the presence of a formation, metastases, fluid in the pleural cavity, etc. However, it does not allow you to see the true picture, but allows you to suspect the disease and prescribe more informative examination methods.
The use of CT or MRI provides clearer information by obtaining a spatial image. In this way, the shape, size, and prevalence of the formation are determined. With MRI, an experienced doctor can give an opinion about the suspected type of sarcoma. In this study, sections of the tumor are examined various levels, which allows for a better assessment of the process.
Angiography is performed to evaluate blood flow to the lungs and tumor. Especially important has when identifying angiosarcoma. Bronchoscopy with biopsy is performed to clarify the morphological composition of the tumor, for differential diagnosis with lung cancer.
Considering the modern level of development of medicine, if you consult a specialist in a timely manner, the diagnosis is made quickly enough.
Treatment and prognosis
The most effective sequence of therapy for sarcoma is:
However, only the attending physician determines the volume necessary treatment in each specific case!
The standard of surgery for sarcoma is wide excision of the tumor in the affected area with surrounding lymph nodes to avoid relapses. This may involve removing a small area (segmentectomy), a lobe (lobectomy), or the entire lung (pulmonectomy).
If the severity of the patient’s condition and the presence of serious concomitant pathology do not allow abdominal surgery, then they resort to more gentle measures. Radiosurgical methods are used to remove the lesion using special knives.
Chemotherapy is carried out with drugs whose action is aimed at stopping the division of tumor cells. The most commonly used drugs: Doxorubicin, Ifosfamide, Cyclophosphamide, Vincristine. It is permissible to prescribe their combinations with other medications.
The dose of radiation therapy, duration and frequency of administration are determined by the oncologist!
Also carry out symptomatic treatment anemia, infectious and inflammatory processes, intoxication. The prognosis depends on the type of tumor, the volume of the lesion, metastasis, and recurrent course. When lung sarcoma is detected in the early stages, every 2 patients survive after 5 years, with late stages– ¼ part. Death occurs in a higher percentage of cases.
Lung sarcoma is an extremely malignant and rapidly progressing type of neoplasm with an unfavorable prognosis, occurring in all age groups.
Sarcoma– a group of malignant tumors consisting of different options connective tissue. Sarcoma most often affects the skin and bones, but can also be localized in other organs: lungs, stomach, blood vessels, lymph nodes. On section, the tumor has the appearance of “fish meat”.
Statistics. Sarcoma is not common - 2 cases per 100,000 population. Its share is 5% of all malignant tumors, but in terms of the number of fatal cases, sarcoma ranks second after cancer. In 40% of patients, the lower extremities are affected.
Risk group. Ewing's sarcoma, or bone sarcoma, affects teenagers and young adults under 35 years of age. Soft tissue sarcoma predominantly occurs after age 50. The risk group includes people with very fair skin and those with weakened immune systems. The ratio of men to women is 6:1, this feature is explained by the fact that some types of tumors depend on the level of sex hormones.
Types of sarcomas by origin:
- osteosarcoma – sarcoma of the bones
- chondrosarcoma – sarcoma of the joints
- myosarcoma – sarcoma based on muscle tissue
- liposarcoma - sarcoma of adipose tissue
- lymphosarcoma - sarcoma of the lymph nodes
- Vascular sarcoma – a tumor of the connective tissue of the vascular wall
- with a low degree of malignancy - consist of more differentiated, mature cells and divide relatively slowly. Such a tumor contains a lot of stroma (normal connective tissue) and few malignant elements.
- with a high degree of malignancy - consist of poorly differentiated cells that divide very often, ensuring rapid tumor growth. This sarcoma has a dense vascular network and contains a large number of malignant cells.
Similarities:
- grow into surrounding tissues and destroy them
- frequent relapses after tumor removal
- formation of metastases in the lungs and liver
- cancer comes from epithelial cells lining the cavities of internal organs, and sarcoma from connective tissue. Therefore, the latter can form on any part of the body
- faster, sometimes “explosive” growth. Metastases form within a few weeks
- sarcoma spreads through blood vessels, and cancer through lymphatic vessels
Causes of sarcoma
- Tissue damage. After injuries and operations, the active process of regeneration and cell division begins. In these conditions immune system it is difficult to identify and destroy undifferentiated cells, which later become the basis of sarcoma. Its appearance can be triggered by:
- scarring
- operations
- foreign bodies
- Chemical carcinogens interact with the cell nucleus, causing mutations in DNA. This leads to disruption of the structure and loss of functions of future generations of cells. Sarcoma can be caused by:
- asbestos
- dioxin
- arsenic
- aromatic hydrocarbons – benzene, styrene, toluene
- Radioactive exposure. Ionizing radiation changes cell DNA and leads to mutations. As a result, the offspring normal cell becomes undifferentiated, that is, malignant. Causes of mutation:
- Previous radiation therapy for another tumor
- consequences of the accident for the liquidators of the Chernobyl nuclear power plant
- working with x-ray equipment
- Viruses damage the DNA or RNA of cells, leading to the formation of a tumor:
- herpes virus type 8
- HIV-1 provokes Kaposi's sarcoma
- Genetic predisposition. In patients, the gene responsible for stopping tumor growth and destroying malignant cells is damaged. This is observed when congenital pathologies:
- Li-Fraumeni syndrome
- neurofibromatosis type I
- retinoblastoma
- Rapid hormonal growth during puberty. Bone cells in adolescents actively divide and, in some cases, immature cells appear. This mechanism is typical for sarcoma of the femur in tall teenage boys.
Symptoms of sarcoma of various organs
Sarcoma can occur anywhere in the body. Symptoms of sarcoma depend on the nature and size of the tumor and the presence of metastases. Clinical manifestations sarcomas are the same as in cancer.Lung damage
Lung sarcoma- enough rare disease, it occurs in 1% of all lung cancer cases. In the initial stages, lung sarcoma does not manifest itself in any way and is discovered by chance during routine radiography.
Lung sarcoma occurs from the walls of the bronchi and the septa between the alveoli. The tumor contains little connective tissue. It is soft, jelly-like with areas of necrosis (cell death). Sarcoma has the appearance of a massive node with indistinct edges, which can occupy the entire lobe of the lung. It is permeated with numerous branched vessels.
Subjective symptoms
- dyspnea– impaired lung function leads to oxygen starvation of the brain, which causes increased breathing.
- fast fatiguability, drowsiness, mood instability - signs of stagnation venous blood in the brain. These phenomena occur when the superior vena cava and innominate veins are blocked, and are associated with impaired blood circulation in the brain.
- pneumonia, not amenable to treatment. Tumor reduces local immunity and promotes the development of inflammation.
- pleurisy develops when the tumor grows into the pleura. At the same time, blood enters the pleural space and inflammation begins.
- dysphagia– difficulty swallowing when the tumor grows into the esophagus.
- enlargement of the right side of the heart. Defeat pulmonary vessels and stagnation of blood in the lungs leads to increased blood pressure in the right side of the heart.
- disruption endocrine glands
and consequences of tumor intoxication:
- thickening of the limb bones
- inflammation of the top layer of bones
- joint pain
- compression of the superior vena cava by a tumor- “kava syndrome”. The outflow from the vein that collects venous blood from the upper half of the body is disrupted. It manifests itself with main symptoms:
- facial swelling
- pale and bluish skin tone
- expansion of the superficial veins of the face, neck and upper body
- Radiography. On x-ray a tumor without clear boundaries is visible. It can range in size from a few centimeters or take up the volume of an entire lung. Lung damage is not symmetrical.
- CT scan reveals heterogeneous round formation with blurred edges and foci of necrosis. The node does not have a shell and grows into the surrounding tissue. Often malignant cells are located along the bronchus in the form of a layer. In this case, the tumor does not have a specific structure.
- Bronchoscopy used if the sarcoma has grown into the walls of the bronchi. When examined, sarcoma is a white-pink formation of irregular shape, without a capsule. A bronchoscope is used to remove a section of tumor tissue for biopsy.
- CT-guided fine-needle biopsy used when the sarcoma is located in areas of the lung that are difficult to reach with a bronchoscope. A hollow needle is inserted into the tumor and a sample of cells is obtained. Histological examination may reveal:
- poorly differentiated cells
- moderately differentiated cells
- highly differentiated cells
- connective tissue fibers
- traces of blood - intact and destroyed red blood cells
- Pleural puncture carried out if an x-ray reveals an increase in the level of pleural fluid. A needle is inserted into the space between the layers of the pleura and fluid is collected for examination. It may reveal:
- leukocytes - indicating inflammation
- atypical sarcoma cells – confirming metastases to the pleura
- red blood cells destroyed and unchanged.
Lymph node involvement
Lymph node sarcoma or lymphosarcoma– a malignant tumor formed from cells of the lymphatic system. The cervical, mesenteric and retroperitoneal lymph nodes are predominantly affected, less commonly the axillary and inguinal ones. Also, a tumor can arise from accumulations of lymph cells located in pharyngeal tonsils and stomach. Common symptoms for various lymphosarcoma
- signs of intoxication caused by the proliferation of malignant cells:
- decreased performance
- temperature increase
- sweating, especially at night
- changes in blood associated with increased destruction of red blood cells and platelets of an autoimmune nature, cause:
- pale skin
- pinpoint hemorrhages on the skin and mucous membranes
- allergy to toxins circulating in the blood is manifested:
- eczematous rashes (grouped small blisters)
Symptoms various types lymphosarcoma.
Lymphosarcoma of the pharyngeal tonsils
- unilateral tonsil damage
- enlargement of the tonsil, it becomes lumpy and cyanotic
- voice change
- nasality
- nasal discharge
- hearing loss
- enlargement of cervical lymph nodes with the formation of metastases
Lymphosarcoma of the cervical and supraclavicular lymph nodes
- enlargement and hardening of lymph nodes
- they are movable, not fused to the skin
- Possible itching over the affected lymph node caused by an allergic skin reaction
- when nearby nodes merge, painless conglomerates are formed
- malaise
- dyspnea
- paroxysmal dry cough
- pale color faces
- bluish lips
- high body temperature
- Almost no wheezing is detected when listening
- compression of the ureter and stagnation of urine in the renal pelvis - frequent painful urination
- lower back pain
- profuse diarrhea leading to rapid exhaustion
- fast weight loss
- ascites – accumulation of fluid in the abdominal cavity
- enlarged spleen
- intestinal obstruction due to a large tumor
- enlarged lymph nodes, palpable through the abdominal wall
Signs of lymphosarcoma detected during instrumental examination
- Blood analysis in most cases no change. Maybe:
- slight increase in ESR
- decreased white blood cell count
- decreased red blood cell count
- decreased platelet levels
- Radiography
- darkening in the lymph nodes
- damage to several lymph nodes
- CT scan– mainly necessary for damage to the lymph nodes of the chest.
- affected lymph nodes merging into conglomerates
- tuberous lobular tumor at the site of the lymph node
- damage to the lymph nodes on both sides of the chest
- Ultrasound– used for lymphosarcoma in the abdominal cavity
- single or multiple lymph node involvement
- heterogeneous tumor structure
- uneven scalloped edges of the tumor
Skin sarcoma
Skin sarcoma or Kaposi's sarcoma– a malignant tumor that occurs from altered cells of the blood vessels of the skin. Its elements are plaques and nodules, consisting of many newly formed blood capillaries and spindle-shaped cells. Skin sarcoma primarily affects older people and people with AIDS. Africans are genetically more prone to the disease. In Africa, the disease has its own characteristics - boys and young men are more often victims.
Symptoms of skin sarcoma
- elements multiple, asymmetrically located painless spots and nodules. Appear on the skin and mucous membranes.
- diameter from 2 mm to 5 cm
- color: Most often purple, brown in older people. Less commonly red, brown, purple. Their appearance caused by a dense plexus of newly formed blood vessels.
- borders clear incorrect. The tumor rises slightly above healthy skin.
- surface smooth or orange peel-like. With a malignant course, ulcers can form.
- bleeding in case of injury, since newly formed tumor vessels are easily damaged.
- localization– most often the feet, legs, hands. In these areas, blood circulation is impaired and local immunity is reduced. Therefore, atypical cells are not destroyed effectively enough.
- the patient's feelings. Complaints of itching and burning are associated with inflammation and an allergic reaction of the skin to products secreted by the tumor.
Biopsy and histological examination for skin sarcoma
- bundles of tangled spindle cells
- hemorrhagic exudate - fluid coming out through the walls of blood vessels
- hemosiderin - a pigment formed during the breakdown of hemoglobin
Bone sarcoma
Bone sarcoma or Ewing's sarcoma- a malignant tumor that primarily affects femurs(70%), humerus (14%), less commonly, scapula, ribs, collarbones, vertebrae, pelvic bones. It is one of the most aggressive - it quickly forms metastases. Most often occurs in adolescents 10-15 years old. Boys get sick 50% more often than girls.Symptoms of bone sarcoma
- Pain syndrome caused by irritation of sensitive nerve endings:
- at the initial stage, the pain is of moderate intensity and may subside on its own
- worsens at night
- does not weaken at rest
- does not weaken when the limb is immobilized - a splint is applied
- After a few months, the pain intensifies and interferes with sleep and daily activities.
- External manifestations diseases associated with local inflammatory process and stagnation of venous blood in the affected area:
- when palpated, the skin over the tumor is painful and hot
- swelling and redness of the skin
- expansion of saphenous veins
- Signs of general intoxication– poisoning by decay products of damaged cells:
- temperature rise to 38 degrees
- loss of appetite
- sudden weight loss
- weakness
- enlargement of nearby lymph nodes
- Organ dysfunction located close to the tumor is associated with rapid growth of sarcoma into surrounding tissues:
- lameness and limitation of movement - inability to fully bend the limb
- dysfunction of the pelvic organs - cystitis, urinary incontinence, violation menstrual cycle, infertility
- with intestinal damage - diarrhea, constipation, intestinal obstruction
- when the spinal nerves are compressed, pain appears in various internal organs - stomach, heart, liver, shooting pains different areas backs
- when the tumor damages the sensitive fibers of the spinal nerves, there is a decrease in sensitivity in various parts of the body, loss of muscle mobility - paresis
- when growing inside the chest - an increase in the amount of pleural fluid, pleurisy, hemoptysis, shortness of breath
- Pathological fracture . After 6-12 months, the tumor reaches a significant size and destroys the bone from the inside, leading to fractures.
- Radiography
- pockets of destruction are visible on the bone, it looks like “moth-eaten”
- inflammation has the appearance of a bulb - “bulbous periostitis”
- blurred contours of the upper layer of bone caused by its disintegration
- growths on the surface of the bone are needle-shaped or layered parallel to the periosteum. Their appearance is associated with damage to the upper layer of bone by sarcoma
- significant soft tissue damage without areas of calcification
- CT scan
- areas of necrosis within the tumor
- living tumor cells are concentrated around blood vessels
- damage to the soft tissue around the tumor that is larger than the tumor itself
- softening of ligaments and tendons near the tumor
- bone marrow lesions
- Tumor biopsy
- small immature tumor cells with large round nuclei
- areas of protein - fibrin, which separate tumor cells and soften bone
- Bone marrow biopsy
- signs of necrosis - dead cells
- spindle-shaped or round cells of large size
- atypical thin-walled cells with large nuclei
- Osteoscintigraphy with Te99
- isotopes are taken up by the primary tumor and small bone metastases that may not be detected by other methods
- Angiography
- contrast agent accumulates in the branched vessels of the tumor
Joint sarcoma
Joint sarcoma or synovial sarcoma– a malignant tumor formed from the synovial membranes and ligaments in the area of large joints. In most cases it affects the knee and shoulder joints. Synovial sarcoma is more often detected in middle-aged women.Symptoms of joint sarcoma
- External signs this is the result of damage to the soft tissue above the tumor:
- protrusion in the form of a lump on the surface of the joint
- the skin over the tumor changes, becomes swollen, and acquires a reddish tint.
- Pain syndrome:
- the pain intensifies with movement, especially if the tumor grows into the joint cavity
- in later stages the pain spreads to the entire limb
- pain is not relieved by painkillers
- Movement disorders. On articular surfaces Roughness and bumps form, which disrupts movement in the joint.
- One-sided defeat - in the vast majority of cases, one joint is affected.
- Limb ischemia. The tumor compresses the blood vessels, leading to poor circulation below the damaged joint:
- muscle pain that gets worse at night
- trophic ulcers
- intermittent claudication - pain in calf muscles, occurring after 30-50 meters of walking
- swelling of the limb
- numbness of the limb
Signs of joint sarcoma revealed by instrumental examination
- Magnetic resonance imaging MRI using contrast agent gadolinium reveals:
- accumulation of contrast agent around the tumor, which allows you to determine its exact size
- detection of small and large metastases
- destruction of surrounding tissue (bone and skin)
- fibering of the periosteum (top layer of bone)
- thickenings on the articular surfaces of the bone
- Biopsy followed by examination of a cell sample
- the degree of malignancy of the cells is determined (low, intermediate or high)
- mucus and blood are detected in the sample
- a large number of atypical giant cells
- Ultrasound
- heterogeneous tumor, inside of which there are cysts filled with blood or mucus
- fuzzy blurred edges of the tumor
- effusion in the joint cavity - a large amount of fluid inside the joint capsule
Adipose tissue sarcoma
Liposarcoma– malignant tumor of adipose tissue. It forms on the fatty tissue of the thighs and abdomen, as well as in the abdominal cavity, where it can reach enormous sizes. The average age of patients is over 50 years. Symptoms of adipose tissue sarcoma
- External manifestations:
- compaction in the thickness of the abdominal wall on the thigh
- An elastic tumor-like formation is palpable through the abdominal wall - a sarcoma, which arises from the fatty capsules of the internal organs.
- Organ dysfunction near which the sarcoma is located:
- intestinal obstruction
- jaundice and indigestion when the tumor grows into the liver
- swelling and urinary retention due to damage to the kidneys and ureters
- menstrual irregularities and pain in the lower abdomen when affected reproductive organs among women
- Pain syndrome not expressed at the initial stages. Pain occurs when the tumor grows inside the organ.
- Ultrasound
- neoplasm different sizes without clear boundaries
- foci of decay inside the tumor
- CT scan
- tumor with heterogeneous structure
- neoplasm without capsule with indistinct edges
- located at the border of subcutaneous fat and muscles or between the abdominal organs
- Biopsy
- atypical cells, the nuclei of which occupy more than a third of the space
- a large number of dead cells (if the sample is taken from an area of necrosis)
- polymorphism (variety of shapes) of cells
Muscle sarcoma
Muscle sarcoma or myosarcoma– a malignant tumor arising from skeletal (rhabdomyosarcoma) and smooth (leiomyosarcoma) muscles. The disease is more often diagnosed in middle-aged and elderly men.Skeletal muscle sarcoma: symptoms:
- predominantly occurs on the extremities
- looks like a pale nodule
- lies deep in the muscles
- palpable as a mobile, dense and elastic knot
- has no clear boundaries because it grows into surrounding tissues
- the tumor is prone to destruction with the formation of ulcers and nodes
It affects internal organs consisting of smooth muscle fibers and disrupts the functioning of the damaged organ.
- pain appears when the tumor reaches a large size and compresses an internal organ
- sudden weight loss. Often observed with damage to the stomach and intestines. Weight loss is associated with impaired digestion and absorption of food nutrients.
- intoxication– poisoning by tumor decay products:
- temperature increase
- weakness
- loss of appetite
- body aches
- sallow complexion
Brain sarcoma
Brain sarcoma– a malignant tumor developing from the connective tissue of the brain and meninges. It can appear at any age.Symptoms of brain sarcoma
- Headache:
- pain is diffuse or corresponds to the location of the tumor
- pain appears regularly and becomes permanent over time
- do not weaken after taking painkillers
- Promotion intracranial
pressure develops when a tumor interferes with the circulation of cerebrospinal fluid in the ventricles of the brain:
- swelling of the optic nerve
- deterioration of peripheral vision
- headache, intensifying in the morning
- dizziness
- vomit
- Violation of voluntary movements:
- convulsions when the brain is compressed, foci of convulsive readiness are formed. In this case, seizures resembling epilepsy occur.
- if the central sulcus in the frontal lobe is damaged, active movements are disrupted - a person loses control over certain muscle groups. Paralysis and paresis develop.
- Focal neurological symptoms, indicating damage to a part of the brain responsible for a certain function.
| Tumor localization | Manifestations |
| frontal lobe | speech disorder |
| occipital part | visual impairment |
| temporal part | hearing impairment |
| parietal lobe | decreased skin sensitivity |
| cerebellum | impaired motor coordination |
| thalamus | decreased memory and attention span |
| limbic structures | emotional disorders– anger, tearfulness, apathy, irritability |
Signs of brain sarcoma revealed by instrumental examination:
- Lumbar (spinal) puncture:
- atypical cells of various shapes and sizes are found in the cerebrospinal fluid
- traces of blood
- Tumor biopsy:
- small cells with a large nucleus containing one or two nucleoli
- The cell cytoplasm is homogeneous, granular
- CT:
- heterogeneous tumor without clear boundaries
- if the tumor is located on meninges, then it may have clear outlines
- signs of sarcoma spreading into brain tissue
- metastases in the lungs and bones
Based on its symptoms, it is difficult to distinguish sarcoma from a cyst, benign or malignant tumor. The type of neoplasm can be determined solely by the results of a biopsy.
Diagnosis of sarcoma
Treatment of sarcoma
Maximum effect in the treatment of sarcoma provides combination therapy. This is surgical removal of the tumor, before or after which a course of chemotherapy and radiation therapy is performed. Thanks to this approach, it is possible to prevent relapse of the disease and increase survival rate from 30% to 70%. The duration of treatment for sarcoma is up to a year.Treatment of sarcoma with medications
| Group of drugs | Representatives | Mechanism of therapeutic action | Mode of application |
| Chemotherapy | Combination of drugs: vincristine, adriamycin (doxorubicin) and cyclophosphamide | The drugs disrupt DNA synthesis, stopping cell division and tumor growth. IN high concentrations lead to necrosis of sarcoma cells. | The drugs are prescribed in a course of 3-4 weeks. After which they are replaced with others to increase the effectiveness of treatment. The drugs are administered intravenously. The dose is calculated individually, taking into account the patient’s weight, shape and stage of development of sarcoma. |
| Combination of drugs ifosfamide and etoposide | |||
| Antitumor drugs, cytostatic group | Oxorubicin, cisplatin, fluorouracil, hydroxyurea, cyclophosphamide | They damage the core and membrane of malignant cells, causing their death and tumor reduction. | The drugs are administered intravenously or intramuscularly daily or every other day. The treatment regimen is selected individually. |
Sarcoma is sensitive to radiation therapy, which complements drug treatment. An ionizing ray emitter is directed at the tumor. Sarcoma is treated with average doses of 45-55 gray. Ewing's sarcoma responds best to radiation therapy.
When is surgery needed to remove a tumor?
This type of tumor is characterized by an aggressive course and early appearance of metastases, so it is necessary to remove the sarcoma as early as possible. The features and technique of the operation depend on the location of the organ and the stage of the disease. Before the operation, a preliminary examination is carried out, which includes:
- general and biochemical tests blood
- testing for HIV, syphilis, hepatitis
- determination of blood clotting
- cardiography
- computed tomography, during which the location of the tumor and the extent of damage to surrounding tissues are clarified.
It removes the sarcoma and 2 cm of healthy tissue around it. Surgeons try to preserve the functions of the organ as much as possible so that the operation does not lead to disability.
Contraindications for surgery
- age over 75 years
- severe diseases of the heart, liver, kidneys
- large tumor vital important organs, which cannot be deleted
Nutrition for sarcoma
Therapeutic nutrition for sarcoma plays a big role. Following a diet helps strengthen the immune system, the body’s natural fight against malignant cells and prevent the growth of metastases. Basic nutritional requirements:
- sufficient amount of vitamins to strengthen the immune system
- easily digestible proteins, which are the building material for antibodies that fight malignant tumors
- large amount of fiber, which speeds up bowel movements and elimination of toxins
- normal fluid intake to cleanse the blood of cell breakdown products
- Vegetables - cucumbers, zucchini, potatoes, tomatoes, beets, eggplants, pumpkin, carrots, onions, garlic. Recommended norm is 500-600 g.
- Greens – dill, parsley, lettuce.
- Fruits - apples, pears, plums, pomegranates, citrus fruits up to 1.5 kg per day.
- Fermented milk products rich in bifido and lactobacteria - fresh kefir, yogurt, yogurt, cottage cheese, as well as fresh goat milk.
- Meat up to 100 g per day. Broths and sausages are not advisable.
- Cereals are a source of complex carbohydrates to maintain strength. Recommended oatmeal, buckwheat and barley porridge. Daily norm – 200 g.
- Nuts and seeds – Brazil nuts, apricot kernels, hazelnuts, cashew walnuts up to 40 g.
- Dried fruits 40-60 g.
- Bran and sprouted grains (2 tablespoons) are a source of fiber, microelements and anti-cancer substances.
- Wholemeal bread up to 300 g.
- Vegetable oils 20-30 g – preferably olive, first cold pressed.
- Fat sea fish– saury mackerel, sardine, herring, cod, trout, salmon.
- Yellow and green vegetables - pumpkin, carrots, green peas, asparagus, cabbage, zucchini.
- Garlic.
- Confectionery– are a source of glucose, which stimulates division cancer cells.
- Tannin-rich foods– tea, coffee, persimmon, bird cherry. Tannin has a hemostatic property, which can lead to the formation of blood clots in patients with sarcoma.
- Smoked products – smoked fish and sausages contain many carcinogenic substances.
- Sour berries– cranberries, lingonberries, lemons. An acidic environment promotes the development of cancer cells.
- Alcohol, especially beer. Brewer's yeast provides tumor cells with simple carbohydrates.
Consequences of sarcoma
- Compression of surrounding organs.
- Formation of metastases.
- Intestinal obstruction and perforation. This situation can lead to peritonitis - inflammation of the peritoneum, which requires immediate surgery.
- Elephantiasis due to compression of the lymph nodes and impaired lymph outflow.
- Deformation of the limbs and limitation of movements due to large tumors in the muscles and bones.
- Internal bleeding caused by tumor disintegration.
One of malignant neoplasms, developing from immature cells of connective tissues, is sarcoma of the lungs and bronchi. The main feature of this pathology is a large number of malignant elements and a high degree of aggressiveness. In cases of primary sarcoma, the neoplasm immediately affects the mesodermal layer of the pulmonary system (interalveolar septa and connective tissues bronchial walls). Secondary damage occurs due to metastases of the tumor, which develops from the connective tissues of other organs.
The most common location of the tumor is the peripheral parts of the upper lobes of the lung, but sometimes the tumor affects the entire organ. IN in rare cases the tumor affects large bronchi and has the appearance of polyps. Basically, the neoplasm is a massive node with a polycyclic or round shape. The consistency of the tumor is soft, and when cut it has a pale pink tint. Oncopathology spreads more often through the bloodstream (hematogenous route).
The development of the disease is more often observed in men aged twenty to forty years. Wherein this pathology occupies only one percent of all types of lung cancer. The disease sarcoma progresses with symptoms such as shortness of breath, cough, pleurisy, pericarditis, pneumonia, and fever. Treatment methods and prognosis depend on which of the four stages the disease is detected at. To make a diagnosis, X-rays, bronchoscopy, biopsy and others are performed. diagnostic measures. Early diagnosis in pulmonology can improve the effectiveness of operations in thoracic surgery.
Any person, especially if he is at risk, needs to know what lung sarcoma is, and also why it can develop. The exact causes of sarcoma have not been established by doctors, but according to statistics, the pathology most often occurs in people who are exposed to ultraviolet radiation, ionizing radiation, and exposure to chemicals. A lot of cases of sarcoma are recorded in areas with polluted and smoky air. Under the influence of these factors, changes occur in the lung tissues, leading to pathological and uncontrolled cell division.
People who smoke or work in hazardous industries with carcinogenic substances such as asbestos, aniline dyes, and pesticides are at risk. People who abuse sunbathing and tanning in solariums are more susceptible to sarcoma. Several times more often, the pathology occurs in those whose family already had cases of sarcoma (genetic predisposition). The secondary type of disease can occur in the chest, soft tissues, and mediastinum.
Stages
The stages of development of lung sarcoma are determined by the size of the tumor and metastasis to other organs. Treatment methods and prognosis of pathology depend on the degree of development of the oncological process. For sarcoma lung tissue there are four stages:
- At the first stage, a single limited node no more than three centimeters in diameter is present in the lung;
- At the second stage, the neoplasm reaches six centimeters in size and metastasizes to the lymph nodes of the root of the organ and to the peribronchial nodes;
- At the third stage, the tumor size exceeds six centimeters, metastases occur in the intrathoracic lymph nodes and grow into the pleural tissue;
- The fourth stage is characterized by a tumor of any size and metastasis to any near and distant organs.
The sooner the patient visits a doctor after the onset of the pathology, the greater the chance of recovery, since this type of cancer progresses very quickly. Unfortunately, early diagnosis is often difficult, since in most cases only at stage 3 the first significant signs appear.
Symptoms
With lung sarcoma, symptoms may appear when the pathology has already reached the third stage. If the tumor grows inside the bronchus, the patient experiences obstruction. With this disease, the symptoms also depend on the stage of development of the pathology. In most cases, sick people experience typical symptoms:
- shortness of breath;
- painful sensations in the chest;
- cough with sputum and bloody streaks;
- increased body temperature;
- increased sweating, especially at night.
When making a diagnosis, the doctor sees foci of necrosis on an x-ray. There is also a violation general condition the patient – constant increasing weakness, fatigue, decreased performance, lack of appetite, loss of body weight. If the tumor grows into the esophagus, dysphagia (problems with swallowing) occurs. When the tumor begins to exert compression on the venous trunks, superior vena cava syndrome develops. When infiltrating into the pleura, the patient is faced with hemorrhagic pleurisy, and into the outer layer of the heart - with hemorrhagic pericarditis.
Diagnostics
Since a neoplasm in the early stages almost never reveals itself clinical picture, diagnostics can be difficult. In rare cases, a tumor is discovered by chance during a routine examination or during routine fluorography. In order to make a diagnosis of lung sarcoma, it is necessary to conduct the following studies:
- general and biochemical blood test;
- computer and magnetic resonance imaging in pulmonology;
- X-ray examination of the lungs or fluorography;
- videothoracoscopy of the chest;
- heart electrocardiogram;
- radioisotropic research;
- contrast angiography;
- fine needle biopsy;
- histological and cytological examination of the biopath.
Only after the above measures have been carried out, the doctor can prescribe pulmonary therapy, depending on the stage of the oncological process, the age of the patient and his general condition.
Treatment of the disease
Sarcoma therapy is carried out using integrated approach including immunotherapy, surgical intervention, chemotherapy and radiation therapy. The most effective is surgical intervention, during which the sarcoma cells and the entire affected segment are removed (segmentectomy). If the tumor is of a significant size, part of the lung lobe may be removed (lobectomy), the entire lobe, or the entire organ (pneumonectomy). In cases where the patient is in in serious condition or surgical intervention is contraindicated for him, the tumor is removed using a cyber-knife (radiosurgery method of treatment).
An appointment is required before the operation. high doses cytostatic drugs, this will help reduce the size of the tumor. For inoperable sarcoma, chemotherapy is performed as palliative treatment. Radiation therapy before surgery complements the effect chemicals, and after tumor removal it helps to get rid of metastases and residual cancer cells, which reduces the risk of relapse. Treatment and prognosis of sarcoma are closely interrelated; much depends on what therapy was given to the patient and how his body responded to it.
Prognosis and prevention
Oncological sarcoma is an aggressive and very dangerous disease, with a very high percentage of deaths. How long people live with this disease depends on the stage at which it was discovered. This cancer pathology is so severe that even if the doctor detects it at the first stage and carries out appropriate treatment, only half of the patients can count on five-year survival. When diagnosed in the second stage, only thirty percent of patients survive.
If a person does not pay attention to the first signs of the disease and consults a doctor already at the third stage, then he has only a five percent five-year survival rate.
The fourth stage is fatal. A person who has advanced the disease to this extent dies within three or four months. The same thing awaits patients with secondary lesion lungs. There is no specific prevention for this pathology, but there are simple rules that can reduce the risk of its development:
- Quitting smoking and other bad habits;
- Wearing a respirator when working with hazardous substances;
- Annual fluorographic examination or x-ray.
Unfortunately, this will not give a 100% guarantee of preventing the disease, but by identifying sarcoma early stage, a person has a greater chance of successful treatment of the pathology.
