Sarcoma causes, symptoms, treatment and prevention methods

Sarcomas are the general name for malignant tumors that are formed from different types of connective tissue. They are often characterized by progressive, very rapid growth and frequent relapses, especially in children. This behavior of sarcomas is explained by the accelerated development of connective and muscle tissue cells at a young age.

• Causes of sarcomas and risk factors
• Development of sarcoma
• Prevalence of sarcoma
• Symptoms
• Diagnostics
• Treatment of sarcoma

Sarcomas are divided into two large groups: soft tissue and bone.

Unlike cancer, which is a malignant neoplasm of the epithelium, sarcomas grow from connective tissue and are not associated with any specific organ, but can occur anywhere in the body. In everyday life, all malignant neoplasms are usually called cancer, but this is incorrect.

Bone sarcomas can develop both directly from bone tissue (paraosteal sarcoma, chondrosarcoma) and from tissues of non-bone origin (Ewing's sarcoma - from mesenchymal stem cells, angiosarcoma - from blood vessel cells, etc.). They can affect internal organs, skin, lymphoid tissue, and the central and peripheral nervous system. The classification, based on the type of tissue from which the tumor was formed, includes the following types:

• osteosarcomas grow from bone tissue;
• mesenchymomas - from embryonic ones;
• liposarcoma - from adipose tissue;
• myosarcoma - from muscle tissue;
• angiosarcomas - from blood and lymphatic vessels, etc.

In total, about 100 different types of sarcomas are known, each of which has its own characteristics of development, treatment and, accordingly, its own prognosis.

According to the degree of tissue maturity, they are divided into low, medium and highly differentiated. The degree of malignancy of the tumor, as well as the tactics of its treatment, depend on this feature: the less differentiated the tumor cells, the more aggressive the tumor and the more serious the prognosis.

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Etiology and pathogenesis

The causes of soft tissue sarcomas have not been identified. Factors that increase the risk of developing this pathology:

• Paget's disease (ostosis deformans);
• Recklenhausen's disease (neurofibromatosis);
• Gardner's syndrome (diffuse polyposis of the colon);
• Werner's syndrome (multiple endocrine adenomtaosis);
• Taking anabolic steroids.

The clinical course of malignant soft tissue tumors is characterized by variability.

Common signs of soft tissue sarcomas include frequent local relapses. Why do sarcomas often recur? This is explained by the following reasons:

1. Lack of true capsule;
2. Tendency to infiltrative growth;
3. Multicentric growth.

Causes of sarcomas and risk factors

Today, there are scientific works proving the role of ionizing radiation, ultraviolet radiation, chemicals, and also some viruses in the development of sarcomas. All these factors cause genetic mutations, which ultimately lead to uncontrolled growth and reproduction of cells.

The rate of bone growth and hormonal levels play an important role in the occurrence of Ewing's sarcoma. Risk factors also include smoking, work in the chemical industry, hereditary conditions, and malfunctions of the immune system.

In addition, among the reasons contributing to the formation of sarcomas are the following: the presence of benign neoplasms (they can become malignant), mechanical injuries, hereditary predisposition, etc.

Diagnosis of soft tissue sarcomas

Diagnostic tests include:

— Examination by an experienced specialist, oncologist; In the photo you can see what soft tissue sarcoma looks like:

- X-ray examination. Allows you to visualize the shadow of the tumor, deformation of the fascial bridges adjacent to the tumor, and identify changes in the bones;

— Ultrasound of soft tissue tumors. This is a method for diagnosing both the primary focus and damage to regional zones. Allows you to determine the boundaries of the tumor, connections with surrounding organs, and tumor structure;

Figure No. 1. Soft tissue sarcoma of the thigh. Ultrasound image in gray scale and vascular imaging modes

— CT scan of the primary tumor, chest and abdominal organs;

— MRI of the primary tumor

Figure No. 2. Soft tissue sarcoma of the upper third of the left thigh

— Morphological verification (puncture biopsy, trephine biopsy) is the most important diagnostic method.

After receiving the results of the examination, laboratory and instrumental diagnostics, the oncologist determines the tactics for managing the patient, according to modern recommendations.

Symptoms

Manifestations of sarcoma can be very different depending on the place of its origin, size and direction of their growth. In most cases, a neoplasm is first detected, which gradually increases in size. As it grows, neighboring tissues are involved, growing into which, the sarcoma damages the nerves and blood vessels in them. This is manifested by a pain syndrome that is poorly relieved by analgesics.

Characteristic symptoms:

• with Ewing's sarcoma - pain in the legs at night;
• with intestinal leiomyosarcoma - progressive signs of intestinal obstruction;
• with uterine sarcoma - intermenstrual bleeding;
• with extraperitoneal sarcoma - lymphostasis and elephantiasis of the lower extremities;
• with mediastinal sarcoma - swelling of the neck, expansion of the saphenous veins in the chest, shortness of breath;
• for sarcomas of the face and neck - asymmetry, head deformation, disturbances in the functioning of the masticatory and facial muscles, etc.

As sarcoma of the extremities develops, skin changes appear above it in the form of redness, dilated veins, thrombophlebitis and a local increase in temperature. The mobility of the arms and legs becomes limited, and dysfunction is accompanied by constant pain.

General principles of treatment of soft tissue sarcomas

Treatment of soft tissue sarcomas should be multicomponent. A council of doctors gathers to determine treatment tactics for the patient.

Basic method:

• Surgical

Additional methods:

• Radiation therapy
• Chemotherapy

Preoperative radiation therapy in combination with surgical treatment can reduce the number of relapses by reducing the malignant potential of the tumor and reducing its volume.

Intraoperative radiation therapy is used, i.e. irradiation of the tumor during surgery in order to suppress subclinical lesions and increase the radiation dose.

Chemotherapy is also used in combination with surgical treatment. There has been a trend towards improved survival rates, but this method is not considered the standard of care for the treatment of soft tissue sarcomas.

Sarcoma: from despair to faith

02.Mar.2020

You can’t just talk about oncology.
Today, “cancer” is synonymous with death for many. People fear not only the disease itself as the cause of their death, but also the suffering that this disease brings to the patient and the people around him. This article does not contain medical statistics on cancer incidence and mortality. Let's leave aside medical terminology. Consider the history of one disease.
The story of one family. One young man. The story continues... Help when you really need it

Last September, Tatyana contacted me through the clinic’s social media page with a request to help her husband. He recently underwent stenting. The man’s condition was alarming and there was no time to delay. Help was provided promptly and, most importantly, in a timely manner. The therapist and cardiologist worked as a single tandem. We continued our communication on VKontakte with the Vartovchanka. It soon became clear that not only the husband, but also the son had health problems in this family.

But first things first.

Spring 2019. Everything was fine: 24-year-old Misha, after graduating from university, received a law degree and got a job. Tall, 2 meters tall, handsome, no bad habits, a young man with healthy ambitions. You have your whole life ahead of you. -I will never forget that morning. My son came up to me in the kitchen and said: “Mom, look, this lump on my left arm, just above the elbow, is bothering me. It appeared not long ago and does not hurt. Maybe it’s the biceps growing? I looked at my hand, touched the tumor, which was already the size of a fist, and experienced some kind of horror. My son quickly made an appointment with a surgeon through Gosuslugi. We were lucky, the reception took place within 2 hours! - says Tatyana. The doctor-surgeon didn’t say anything terrible or specific, but immediately sent me for an ultrasound examination of soft tissues. Nothing definite was revealed there either. Just a tumor. Next was an x-ray. It showed that everything in the bone tissue was normal. “We wanted to immediately do magnetic resonance imaging of soft tissues, but in our city at that time there was no technical capability to study the forearm area specifically. I enrolled my son in the Surgut clinic. It rained the entire 3 hours we were driving. This is very rare for our region... There were no tears then. There was hope that it was just a tumor and everything would be fine, recalls Mikhail’s mother. After the examination, the doctor gave the results and recommended a consultation with an oncologist. “I received the results alone, and I read the conclusion myself: “A formation similar to a sarcoma of the soft tissues of the left forearm.” Before this, I had already studied information about a tumor that could be on a young man’s arm. Sarcoma has been described as a disease of the young with unpredictable consequences. The floor is gone from under your feet! But an inner voice kept repeating: maybe it’s a mistake. It’s a mistake...” the upset woman continued her story, brushing away a tear that had rolled.

Just get home

Tatyana’s heart sank in pain, a premonition of trouble settled in her head. I had to somehow get myself together and say something to my men in order to get home safely. Her husband and son were in the car when she reported that a malignant tumor was suspected. The decision came instantly: I urgently needed to undergo an examination at home. Upon their return, the family contacted the head of Polyclinic No. 1, Flyura Samakhuzhina, with a report. A full examination was immediately organized here. And then they sent me to the Oncology Dispensary. — Our son is a great optimist, he always reassured me. My hand doesn’t hurt, which means everything will be fine. But I already knew everything about the consequences of sarcoma. Hurrying up means improving the forecast. I went to the website of the District Clinical Hospital of Khanty-Mansiysk. There they described the capabilities of the Oncology Center in the diagnosis and treatment of tumors. The website contained the phone number of the chief physician, Elena Kutefa. I called. No one answered me right away - my mother comments. In the evening of the same day, Elena Ivanovna called back herself. She listened carefully and reassured the worried mother. At the end of the conversation, she offered to come to Khanty-Mansiysk. The hospital will definitely help. There was so much confidence and compassion in this voice that the family from Nizhnevartovsk had no doubt that they were expected. The young patient turned to the Nizhnevartovsk Oncology Center for a referral to the district hospital. A local oncologist-surgeon immediately spoke about amputation. There was no other way. But the referral was issued. The next day, the deputy head of oncology, chief freelance oncologist of the Ugra Department of Health, Evgeniy Bilan, contacted the young Vartovo resident from the hospital. He told where and who to contact at the OKB upon arrival. - Of course, there were tears. But I remembered Bilan’s words, spoken even a little harshly and like a man: “You stop inventing something that doesn’t exist yet and everything will be fine with your son.” They were the ones who brought me to my senses and gave me hope,” Misha’s mother shares her sobering impression.

About hope and humanity

The family flew to Khanty-Mansiysk. They were received without queues, the patient was hospitalized for a biopsy. After 2 weeks the diagnosis was confirmed. The tumor on my arm grew very quickly. After a consultation at the district hospital, they decided to send Misha to the Federal Oncology Center. Doctors conducted a full examination of all organs and found no metastases. “It gave us hope and faith that everything would be fine.” Our son did not yet know that he was facing amputation of his arm. I couldn't tell him about this. There was still hope that in Moscow they would be able to save not only a life, but also a hand, says Tatyana. The head of the oncology center, Evgeniy Bilan, and the surgeon, top oncologist Pavel Grigoriev, decided that the patient should know everything about his diagnosis. They told him about the consequences, but did not rule out that the federal center would be able to save his arm. Misha behaved like a real fighter! He consoled his mother and even joked with the doctors. As the young man’s family noted, the most important thing that medical specialists did was to give Misha their contacts and the opportunity to turn to them in the most difficult moments. Just talk and get help. Sensitivity is especially valuable in such moments. Not only was Misha provided with qualified medical care, the doctors showed maximum human attention. Then in Khanty-Mansiysk, a young Vartovo resident was diagnosed with embryonic sarcoma of the soft tissues of the left forearm, grade 3 of malignancy. He was sent to the Federal State Budgetary Institution National Medical Research Center for Oncology named after. N.N. Blokhin" of the Russian Ministry of Health to the capital. — Understanding that you are not alone in the fight against your disease gives you strength to move on, to defeat cancer. But it was necessary to fight seriously. My son's diagnosis is a rare disease. Only 1 case per 200 thousand population. He was the youngest in this adult world, Tatyana continues. At the National Medical Research Center of Oncology named after. N.N. Blokhin, on the recommendation of doctors from the Khanty-Mansiysk District Clinical Hospital, a family from Nizhnevartovsk was met by telemedicine specialist Natalya Sushchevskaya. Misha was scheduled for consultations with specialists from the center, additional examinations were carried out. Based on the results, the medical council prescribed treatment - polychemotherapy courses (PCT) at the place of residence. The Nizhnevartovsk Oncology Center was already prepared for the appearance of such a young and very complex patient. High-dose chemotherapy was prescribed. Doctors and relatives feared how Misha would cope with it. Under the leadership of the head of the chemotherapy department, Victoria Mikhalyuk, the oncologists carried out their assignments at the Russian Cancer Research Center in a highly professional manner. N.N. Flea treatment. But after control studies, the tumor only grew. The patient's arm was almost painless and working. There were still 6 courses of high-dose chemotherapy ahead of the operation. “Our oncologists competently and professionally organized the entire treatment process. The son really wanted to live and keep his hand. He never whined, he followed all the doctors’ orders - the mother continues - Everyone helped us, even a specialist from the press service of the Nizhnevartovsk city clinic. By contacting the social network Vkontakte through the official page of a medical organization, we could quickly organize consultations with medical specialists for Misha between chemotherapy courses. Therapist Maria Leonova, although not from our site, accompanied us all this time. She was constantly in touch through the press service and promptly resolved all emerging issues and prepared the necessary documents. We always flew to Moscow with a full set of all tests and consultations, my mother says with gratitude. The operation could be scheduled at any time. The family visited the capital's cancer center two more times. Then control and adjustment of treatment was required. Everyone hoped that the tumor would shrink. However, after courses of chemotherapy it only increased, and pain in the fingers appeared. Misha was again sent to the district clinical hospital of Khanty-Mansiysk for a PET CT scan. The conclusion confirmed: the tumor is growing. There was some positive news too. There are no metastases anywhere. Evgeny Bilan and Pavel Grigoriev were able to convince the guy that life goes on and what it will be depends on him. — We felt great moral support and care. The son was already ready to have his arm amputated and wanted it done in Khanty-Mansiysk. But the doctors at the Moscow center insisted on completing the course of PCT and returning to the consultation to prescribe further treatment, Tatyana continues. To save lives, the Family flew to Moscow. On the same day, an MRI examination of the tumor was performed. The result was worse. Misha was invited to a consultation, where a decision was made: in order to save his life, his arm must be amputated. - It was a shock. Until recently, I looked at my problem with optimism. There was hope. But it was suddenly broken! After about twenty minutes I calmed down. Accepted it as is. Most likely, I just didn’t want to think about bad things at that moment, I didn’t want to stress myself out. It is necessary to amputate for the sake of life - that means it is necessary. I’ll decide the rest later,” recalls Misha, who wished to hide his real name. For eight months, a Nizhnevartovsk family struggled with a terrible disease. 6 courses of high-dose chemotherapy are the price of saving a young person who has not yet really seen life. The arm subsequently had to be amputated. The operation was performed by excellent surgeons. For them it was an ordinary, not complicated operation. Vartov residents were given a separate ward. The mother was allowed to be with her son for 5 days. All the staff cared for the patient with special attention. It was clear that no one was indifferent to the fate of the young guy. According to the parents, the son was already distinguished by his intelligence and intelligence, but during the treatment he became quite an adult. With his behavior and faith that they could cope, he helped all members of his beloved family survive. There were no hysterics. There were tears that Misha tried not to show. My father, like many men, carried everything within himself. He worked and earned money to get his son out. No one allowed the thought that it could be any other way. They knew for sure that they would be helped. The son will live. While Misha was under observation at the National Medical Research Center named after. Blokhin’s doctors tirelessly monitored his psychological state. “He cried so much, my big and little boy... He kept asking: “Why?” For what?!" My already far from young body could not stand it. From everything I saw, I lost consciousness - the exhausted mother again remembers her blow. Tatyana woke up in the nurse's office. My blood pressure dropped sharply due to stress. After the injections the woman felt better. She returned to her son's room. Misha slept under the influence of a sedative, and his mother drank sweet tea, carefully prepared by the nurses, and came to her senses. The psychologist talked with Misha for a long time. Little by little, he began to return to life, realizing and accepting the harsh reality. After 3 days I was allowed to get up. Mother and son began to walk around the center. Life was getting better. From the very beginning, the young man tried to do everything himself. Of course, it didn’t work out right away. I was tormented by phantom pain in an arm that was not there. It's very scary when something that doesn't exist hurts. But he didn’t cry anymore and even calmed his mother down. The Russian Cancer Research Center immediately registered the disability, and on the 5th day the family received all the necessary documents. Complete strangers and seemingly strangers, but at the same time real professionals in their field, doctors gave a lot of warmth and care to a small family from Nizhnevartovsk. The main thing is that they found hope and faith that they could cope together.

Forward to new horizons

At home, in the Nizhnevartovsk oncology clinic, the young man continued to communicate with a psychologist, now local. He liked it. This helped me overcome my fear of the future and outline serious prospects in life. “Probably, there is still a guardian angel who sent us caring people during this very difficult time for our family.” We flew home on Saturday morning, but the oncology department was already waiting for us. Nobody canceled the phantom pain, and we ran out of painkillers. We contacted the therapist again and were invited to an appointment to prescribe the necessary medications. In addition, on this day, the surgeon of clinic No. 1 examined what was left of the hand. Misha was bandaged. We got painkillers. Our oncologists were ready to administer 4 more courses of prescribed chemotherapy. It would seem that the hand was not saved... But everyone who helped this family breathed a sigh of relief. There is no longer a threat to life. — Our family is learning to live in new conditions. From the very beginning, the son tries to be independent and independent of other people's help. So far we have ordered a cosmetic prosthetic arm. After remission, he will be able to work, the father of the family talks about his plans for the future. Misha has a big dream - to install a bionic prosthesis that can do almost anything! To do this, remission must occur for at least a year. It costs a lot of money. Mikhail is young and full of ambition. He has a legal education and managed to work in his specialty. I have always been interested in history. Even before my illness, I wanted to get a second higher education with a degree in History Teacher. Now that the “side effects” from chemotherapy are passing, Misha continues to prepare and wants to enter Nizhnevartovsk University this year. However, nothing prevents him from working as a lawyer. With his desire to live, work, and help people, he will succeed. While this material was being prepared, I spoke in turn with Tatyana and Misha. This is their way of speaking. The family would like to thank everyone who has been and is with them during this difficult time. And the main thing is to set an example of resilience and optimism to all those who are faced with the disease.

— It’s very difficult to single out someone in the oncology clinic, in the clinic or in other medical organizations that we visited... All the staff simply did their job very well, and nothing human is alien to them. I would like to note that in such a situation you need to knock on all doors and they will definitely open and help you. Contacts and hotline numbers are indicated in each medical institution and on official websites. The first thing to do if trouble strikes is to seek help from professionals. They will answer you exactly and guide you on how to act. Never try on a similar, but someone else’s diagnosis and treatment method, as everything is strictly individual. We must live and fight, and not look for the guilty. Set priorities, live here and now. Unfortunately, there is always a risk that the disease may return and this must be remembered. Follow doctors' orders and just live. Instead of an afterword It is important that those who are now sick know about the stories of those who were sick before them. About those who recovered, who won, grew their hair, started a family, gave birth to children. This is as important a part of treatment as therapy. The Nizhnevartovsk family was helped by the story of Alexander Bocharov’s victory over sarcoma. I got sick in the 11th grade and lost my leg while fighting the disease. Now he, the father of two children, helps everyone who turns to him. Having gone from despair to faith, every patient should know that cancer is a horror. But it can and must be fought. On my own behalf, I will add: you need to win!

Evgenia Pastukhova, public relations specialist at the Nizhnevartovsk City Clinic

How does sarcoma develop?

Genetic changes lead to a chaotic division of connective tissue structures. The tumor grows, invades nearby structures, and destroys them. Typically, the lower the degree of differentiation of structures, the more malignant the disease. With the development of formation, atypical elements are distributed in the body with the blood or lymph flow, collecting far from the location of the primary formation, forming secondary areas of metastasis. Therefore, even with radical treatment, relapse processes are not uncommon.

As the tumor progresses, it grows into other tissues, disrupting their functions; in addition, pain syndrome develops (due to ingrowth into nerve trunks), the swallowing process is disrupted (if the esophagus is affected), and breathing failures are present (when the trachea is affected). Most often, at the site of the incision, the sarcoma tissue is soft, elastic, white-pink in consistency (like fish meat), in addition, they do not have clear boundaries - the tissue gradually turns into normal tissue. Due to the fact that sarcomas exist in many variations, it should be noted that some of them progress very slowly (for example, parosteal bone sarcoma), others have a very rapid progression (rhabdomyosarcoma), while liposarcoma is distinguished by simultaneous or sequential formation in several locations.

Forecast

In the past, osteosarcoma was one of the malignant tumors with the most unfavorable prognosis. Even though the treatment included severe mutilating operations, the five-year survival rate did not exceed 5–10%. Currently, due to the emergence of new treatment methods and the use of effective organ-preserving operations, patients' chances of a successful outcome have increased significantly even in the presence of metastases in the lungs. Today, the 5-year overall survival rate for localized osteosarcoma is more than 70%, while patients with the metastatic variant have much worse outcomes (5-year overall survival of about 35%).

Unfavorable prognostic factors continue to be early development of relapse, multiple foci and pleural involvement (in the presence of pulmonary metastases).

Bibliography:

1. Federal clinical guidelines “Malignant neoplasms of bones and articular cartilage: osteosarcoma, Ewing’s sarcoma” (approved by the Ministry of Health of Russia).
2. Scientific and clinical protocol EURAMOS-1.
3. Aliev M.D. Malignant bone tumors. Sarcomas of bones, soft tissues and skin tumors 2010; 2:3–8.
4. Pediatric oncology: Clinical guidelines for the treatment of patients with solid tumors. / edited by M. Yu. Rykov, V. G. Polyakov. - M.: GEOTAR-Media, 2021. -368 p.
5. Pediatric oncology. National leadership / ed. M D Alieva [and others]. - M.: Publishing group RONC, Practical Medicine, 2012. - 684 p.: ill.

How does sarcoma develop?

Is sarcoma cancer?
Official medicine in Russia and some other countries refers to cancer as malignant tumors that develop in epithelial cells contained in the skin or mucous membranes and lining the inner surface of organs. Sarcomas are not tied to specific organs, they form in different types of tissues, but behave in a similar way - they grow quickly, damage healthy cells and metastasize. Metastasis is an additional focus of cancer - a new tumor in an organ located far from the main tumor, including in lungs, bones and liver.

The disease begins with the appearance of just one mutated or altered cell. It becomes this way under the influence of radiation, various chemicals, diseases or hereditary characteristics, and gradually multiplies, creating copies of itself. Over time, they become more and more numerous, they turn into a tumor and destroy surrounding tissues. In addition, they have a special, very dangerous property - they know how to move around the body using the circulatory and lymphatic systems. The lymphatic system complements the cardiovascular system. The lymph circulating in it - the intercellular fluid - washes all the cells of the body and delivers the necessary substances to them, taking waste from them. In the lymph nodes, which act as “filters,” dangerous substances are neutralized and removed from the body, become established in other areas of the body and create additional tumors.

Classification

According to the WHO classification, there is a localized (locally advanced) version of osteosarcoma - 80% and a generalized (metastatic) - 20% of cases. Based on the examination of the material obtained through biopsy, the pathologist gives a histological assessment of the tumor. Tumors are divided into central (high and low grade of malignancy), superficial, intracortical, gnotic, extraskeletal and secondary - associated with Paget's disease, radio-induced, as a rule, this is a variant of high grade of malignancy.

In addition to histological classification, the TNM system is used, which evaluates the size of the tumor, the extent of damage to regional lymph nodes, the presence or absence of distant metastases, and the degree of differentiation of tumor tissue.

Based on the data from instrumental studies and histological findings, the disease is staged.

Rehabilitation

Rehabilitation measures after the surgical stage of treatment depend on the volume and type of intervention. The principles, duration and outcomes of rehabilitation largely depend on the latter.

To achieve maximum functional results, it is necessary to follow the basic principles of rehabilitation

1. Gradually increase the intensity of exercises on the surgical area.
2. Maintain regular exercise.
3. You should perform restorative exercises aimed at the entire body.

Rehabilitation activities are divided into several stages, including:

• The first (early) period begins immediately after surgery, after removal of the drainage system. As a rule, this is the second and third day after surgery. The main goal is to ensure that the exercises are aimed at minimizing the load in the area of ​​surgical intervention, while maximizing the range of motion in the joint without stressing the muscle and bone structures.
• The second period involves a gradual increase in muscle activity.
• The third period is aimed at increasing muscle mass.

During surgical interventions on the lower extremities, all stages of rehabilitation should alternate with regular walking with a gradual increase in load. The first steps should be taken with the help of a walker, on crutches, with a stick and then without support.

What are sarcomas?

Sarcomas are tumors that form in the structure of bones, muscles, fatty tissue near muscles or inside nerves. There are many varieties of this pathology (approximately 50). The large number of subtypes can be explained by the very nature of the tumor, which can develop from various tissues. Sarcoma is considered a complex, rather rare pathology. So here it is especially important to contact a specialist with extensive experience who can accurately diagnose the problem in order to begin an effective course of treatment for sarcoma abroad.

Approximately 10% of such soft tissue tumors involve the head and neck, about 30% - the torso (of which 40% affect the organs of the abdominal cavity, retroperitoneal space), 60% - extremities (with legs 3 times more often than arms). As for bone sarcomas, they are less common than soft tissue tumors of the same name (only 0.2% of low-quality tumors). Bone sarcoma forms mainly inside long tubular bones, mainly in the lower extremities (the area of ​​the knee joints). The upper part of the humerus is the second most common area for this type of sarcoma. Much less often, osteogenic sarcoma is diagnosed in places such as the fibula, lower jaw, clavicle, flat pelvic bones, spine, etc.

Sarcomas are grouped based on the type of tissue from which they are formed (bone, embryonic, adipose and

etc.). The tactics also depend on the type of pathology: for example, treatment of osteosarcoma abroad will differ significantly from therapy for angiosarcoma.

Formations of this type can be found both in children and in adults. There are forms that are more common among children (for example, Ewing's sarcoma) or among adults (chondrosarcoma, stromal tumors of the gastrointestinal tract). Every 2nd case of bone sarcoma, as well as every 5th case of soft tissue sarcoma, is detected in people under 35.