Etiology of Sarcoma
The etiology of malignant soft tissue tumors is not well understood. About 2/3 of soft tissue tumors are located on the limbs in the area of large muscle masses. Symptoms of soft tissue tumors are usually scanty. The first symptom is most often a palpable tumor. Symptoms such as ulceration, swelling of the limbs, and pain are usually late. Clinical manifestations depend on the histological structure of the tumor.
Alarms, in the presence of which one can assume sarcoma of soft tissues, are: 1) a gradually increasing tumor formation;
2) restriction of tumor mobility;
3) the appearance of a tumor emanating from the deep layers of soft tissues;
4) the occurrence of swelling after a period of time from several weeks to 2-3 years or more after injury.
Auxiliary research methods are radiological (panoramic radiographs, angiography, phlebography, pneumography, computed tomography), ultrasound, thermography, nuclear magnetic resonance.
The final diagnosis is established only on the basis of cytological and morphological studies.
The international classification according to the TNM system is applied only to malignant tumors.
T – primary tumor:
T 0 – primary tumor is not determined; T 1 – tumor with a diameter of 5 cm or less in the largest dimension; T 2 – a tumor with a diameter of more than 5 cm, but without damage to the bones, main vessels or nerves; T X – insufficient data to evaluate the primary tumor. N – regional lymph nodes: N 0 – there are no signs of damage to regional lymph nodes; N 1 – there are metastases in the regional lymph nodes; N X – insufficient data to determine the defeat of regional lymph nodes. M – distant metastases: M 0 – no signs of distant metastases; M 1 – there are distant metastases; M X – insufficient data to determine distant metastases; G – histological gradation: G 1 – high degree of differentiation; G 2 – the average degree of differentiation; G 1-4 – a low degree of differentiation or undifferentiated tumor; G X – the degree of differentiation is not installed. Grouping by stages: stage IA – G 1 T, N 0 M 0 ; stage 1B – G 1 T 2 N 0 M 0 ; stage ON – G 2 T 1 N 0 M 0 ; stage 11B —G 2 T 2 N 0 M 0 ; stage IIIA – G 3 , G 4 T 1 N 0 M 0 ; stage IIIB – G 3 , G 4 T 2 N 0 M 0 ; stage IVA – any category G, any category TN 1 Mo; stage IVB – any category G, any category T, any category N M 1 .