Soft tissue sarcomas occur in soft (usually elastic) tissue which a growing tumor can easily push into and for that reason, it is not often for symptoms to appear in the early stages of sarcoma. Additionally, routine screening tests with the capability to detect sarcomas before symptoms appear have yet to be developed.
In cases where symptoms present themselves, a sarcoma tumor usually begins as a painless lump and eventually, the tumor can cause some pain or soreness if it impinges on nerves and muscles. With abdominal sarcomas, a tumor can cause blockage in the gastrointestinal system or blood in vomit or stool can manifest.
It is very important to know that symptoms such as these can be caused by another medical condition and not cancer; if symptoms present themselves, it is imperative to consult a physician. If you feel that you have symptoms indicating the presence of sarcoma, please don’t hesitate to contact the Sarcoma Oncology Center to schedule a consultation. We are available to answer any questions and help with medical concerns that you might have.
Medical History & Physical Examination
Doctors use medical history and physical examination to discuss any symptoms and risk factors as well as get an understanding of a patient’s general health and information about any signs of sarcoma.
Imaging studies can identify masses and are crucial to good clinical management. Some of the more frequently used tests include:
Because sound waves reflect differently off of tumors than normal tissues, ultrasound can sometimes identify a mass for biopsy.
Computed Tomography (CT)
X-ray images are taken of the body from different angles, and then combined by a computer to produce a cross-section picture of the inside of the body. For surveillance during follow-up, PET/CT (positron-emittance tomography and computed tomography) is now often a combined study. Combination PET/CT shows both the location and the metabolic signal of actively growing cancer cells when a tumor is present. If the PET/CT study indicates a recurrence, the doctor might order a separate CT study for precise information about the tumor’s location.
Magnetic Resonance Imaging (MRI)
This process is similar to a CT scan but employs large magnets and radio waves to produce the images. One advantage of MRI over CT scan is MRI’s capability to show blood vessels in greater detail and to picture cross-sections from multiple angles.
In a biopsy, the surgeon removes a sample of the tissue from the tumor so that it can be microscopically examined by a pathologist. In some situations, signs or results of imaging studies are so clear as to indicate the need for surgery even before a biopsy is conducted. Yet, even in these situations, a biopsy is performed on excised tissue to verify the tumor is a sarcoma and not another type of cancer or a noncancerous growth.
Biopsy also enables doctors to determine the type of sarcoma and its grade which is a predictor of the risk of metastasis. Accurate diagnoses based on molecular makeup are now feasible because over the past ten years, cancer genes have mutated into many different soft tissue sarcomas which can be uniquely identified.
There are several different types of biopsy procedures:
Fine Needle Aspiration Biopsy
In fine needle aspiration biopsy, a doctor uses a fine needle and a syringe to remove tiny pieces of the tumor for microscopic examination. This procedure is sometimes used to determine if a suspicious mass is actually a benign tumor or cyst. In some cases, the mass can indicate an infection or some other disease. If examination of the cells indicates sarcoma, incisional biopsy or core needle biopsy may be required to confirm the diagnosis and determine the aggressiveness (grade) of the cancer.
In an incisional biopsy, a surgeon cuts through the skin to remove part of a tumor which is then examined microscopically. An incisional biopsy is usually an outpatient procedure with general or local anesthesia. Previously, almost all patients with soft tissue sarcoma in the extremities had to undergo an incisional biopsy prior to treatment. Today, less than one third need an incisional biopsy.
Core Needle Biopsy
In core needle biopsy (also known as Tru-CutR biopsy), a surgeon removes a cylindrical tissue sample about 1.5 millimeters across. This is an outpatient procedure, performed under local anesthesia allowing patients to go home on the same day. Memorial Sloan-Kettering doctors have found that core needle biopsy is as effective as incisional biopsy in diagnosing soft tissue sarcoma of the extremities. The procedure is less invasive and less painful for the patient and results are quicker than with an incisional biopsy.
Diagnosis: The Next Phase
With advances in molecular and genetic technology, pathologists should soon be able to know which drugs will be effective against the molecular make-up of a particular tumor.
Contact the Sarcoma Oncology Specialists Today
Sarcoma Oncology Center offers patients the best possible solution and considers the physical and emotional well being of each patient. Please contact our center at 310-552-9999 to schedule a consultation with one of our oncologists to discuss your personal situation and answer your questions.
Learn more about the Sarcoma Oncology Center physicians.