Favorite localization – soft tissue of the limbs. Arising in the thickness of the muscles, as a rule, does not lead to functional changes. On examination and palpation, a firm, fine-tuberous, well-defined, round, painless tumor, covered with unchanged skin, and rapidly growing is determined. Metastases in the lymph nodes occur in 5-8% of patients.
Hematogenous metastases rarely develop. The usual route of hematogenous metastasis is to the lungs. Treatment consists in a wide excision of the tumor. In the presence of metastases in the regional lymph nodes, regional lymphadenectomy is used. The tumor is not very sensitive to radiation and chemotherapy. The forecast is satisfactory.
It grows in the form of a limited node, sometimes reaching very large sizes. The clinic depends on the degree of tumor differentiation. Highly differentiated tumors grow slowly, bother the patient a little, they are usually an accidental find, poorly differentiated tumors grow quickly and reach large sizes in a short time. On examination and palpation is determined soft elastic, round, lobed, painless, limited tumor, covered with unchanged skin. Hematogenous metastasis to the lungs, liver, heart, spleen, brain is characteristic. Treatment consists in a wide excision of the tumor. A little sensitive to radiation and chemotherapy. The prognosis depends on the degree of tumor differentiation.
It develops from the elements of striated muscles. Histologically distinguish pleomorphic, alveolar, embryonic (botrioid), mixed forms of rhabdomyosarcoma. The main symptom is the presence of a tumor node of a soft or densely elastic consistency in the thickness of the muscles. The boundaries of the tumor are fuzzy. It grows rapidly, accompanied by the expansion of saphenous veins. Often the skin grows with the formation of exophytic bleeding formations. Relapses early. Metastasis to the regional lymph nodes is rare, very early metastasis to the lungs is characteristic. Treatment consists in a wide excision of the tumor. With extensive damage, amputation or exarticulation of the limb is performed. The forecast is unfavorable.
Angiosarcoma develops from the blood and lymph vessels. Histologically classified on the basis of cellular origin: hemangioendothelioma, hemangiopericytoma, lymphangiosarcoma and Kaposi’s sarcoma. The latter is considered as HIV-associated sarcoma. The tumor node soft elastic consistency, does not have clear boundaries, poorly displaced by palpation. It grows rapidly, infiltrating the surrounding muscles and venous vessels, which sometimes leads to the appearance of edema. With Kaposi’s sarcoma, there are multiple nodules. Often metastasizes to regional lymph nodes. Hematogenous metastasis to the lungs, internal organs and bones is characteristic. The treatment is the same as with rhabdomyosarcoma. The tumor is slightly sensitive to radiation therapy. The forecast is unfavorable.
Synovial sarcoma (malignant synovioma). It arises from the synovial membrane of joints, tendons, vagina and fascia. It has no typical symptoms. Usually it is a painless or slightly painful tumor of dense consistency, poorly displaced. Damage to the adjacent bone is often expressed. Glandular (cellular) synoviomas often metastasize to regional lymph nodes. Fibrous synovioma in the lymph nodes rarely metastasizes. Both forms are characterized by hematogenous metastasis to the lungs. Surgical treatment – a wide excision of the tumor. Weakly sensitive to chemotherapy. The forecast is unfavorable.
Malignant neuromas (malignant neuroma, malignant schwannoma, neurogenic sarcoma) is a tumor from the elements of the Schwann membrane of the peripheral nerves. Reliable diagnosis is possible only on the basis of histological examination of a removed tumor or biopsy. In the initial stages, a soft-elastic, painless tumor with fuzzy borders is determined. Growing slowly. With a superficial location, skin can germinate, but ulceration is rare. Surgical treatment – a wide excision of the tumor. The forecast is unfavorable.