Neoplasm » Specific tumours

Sarcomas

Sarcomas include bone sarcomas (e.g. osteo sarcoma, chondrosarcoma, Ewing's sarcoma and malignant fibrous histiocytoma) and soft tissue sarcomas (fibrosarcoma, rhabdomyosarcoma, liposarcoma, leiomyosarcoma, synovial sarcoma, neurofibrosarcoma, malignant fibrous histiocytoma). Sarcomas cause very few symptoms, in early stages. Pain or locally increased skin temperature seen in bone sarcoma occurs only at a later stage and when they are fairly large. Soft-tissue sarcomas are usually painless even in the late stage. Spread of sarcomas is mainly via the bloodstream; rarely to local lymph nodes. Sarcomas send metastases typically to the lungs. Basic management consists of an appropriate combination of surgery, radiotherapy and chemotherapy. Soft-tissue sarcomas are removed surgically with a wide margin (4-6 cm). Chemotherapy is used in metastasized cases or to reduce the size of the tumour before surgery. The treatment of bone sarcomas depends on their histological structure. In low-grade malignant bone sarcomas radical surgery is usually sufficient. Surgery is the best alternative also in malignant fibrous histiocytoma and in chondrosarcomas. In high-grade malignant (Grade III-IV) osteo - and Ewing sarcomas treatment is started with aggressive chemotherapy. A few weeks later either radical surgery is performed or the patient receives radiotherapy and chemotherapy with the same or new drug combination is continued for 6-9 months.

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