Sarcomas

Sarcomas are a diverse group of cancers that arise from mesenchymal tissues, including bone, cartilage, fat, muscle, and connective tissue. They are distinct from carcinomas, which originate from epithelial cells.

They are categorized into soft tissue sarcomas and bone sarcomas. Soft tissue sarcomas encompass more than 50 histologic subtypes, such as liposarcoma, leiomyosarcoma, synovial sarcoma, and undifferentiated pleomorphic sarcoma. Bone sarcomas include osteosarcoma, chondrosarcoma, and Ewing sarcoma. Classification relies on the cell type they resemble and their genetic features.

Sarcomas are rare. Soft tissue sarcomas account for a small fraction of adult cancers and a higher share of pediatric cancers. Risk factors include prior radiation exposure and certain inherited conditions, such as Li-Fraumeni syndrome and neurofibromatosis type 1, among others.

Clinical presentation typically involves a lump or swelling that enlarges over time; pain may occur with larger or deeper tumors. Diagnosis combines imaging (often MRI or CT) to define extent with a biopsy to determine histology and grade. Staging considers tumor size, depth, metastasis, and nodal involvement.

Treatment generally centers on surgical removal with negative margins when feasible. Radiotherapy is commonly used to reduce local recurrence, and chemotherapy is standard for some bone sarcomas and select soft tissue sarcomas. In unresectable or advanced cases, targeted therapies or immunotherapy may be used for specific subtypes.

Prognosis varies widely by histologic subtype, grade, size, location, and presence of metastasis at diagnosis. Early detection and comprehensive multidisciplinary care improve outcomes. Follow-up includes regular imaging and physical examinations to monitor for recurrence or late effects of treatment.