Sarkome

Sarkome, or sarcoma, refers to a group of malignant tumors that arise from mesenchymal tissues, including bone, cartilage, fat, muscle, and connective tissue. They are distinct from carcinomas, which originate from epithelial cells. The term covers a diverse set of tumors, generally categorized into soft tissue sarcomas and bone sarcomas.

Soft tissue sarcomas originate in fat, muscle, nerves, fibrous tissue, blood vessels, or other connective tissues; bone sarcomas arise in bone and related cartilage. Examples of soft tissue sarcomas include liposarcoma, leiomyosarcoma, synovial sarcoma, rhabdomyosarcoma, and undifferentiated pleomorphic sarcoma. Bone sarcomas include osteosarcoma, chondrosarcoma, and Ewing sarcoma. Many sarcomas are high-grade and may metastasize, most commonly to the lungs.

Risk factors include inherited cancer predisposition syndromes (such as Li-Fraumeni syndrome and RB mutations), prior radiation therapy, and certain chemical exposures; many cases are idiopathic. Symptoms typically present as a painless lump or swelling, with pain or functional impairment if the tumor affects nerves or joints.

Diagnosis relies on imaging—MRI is preferred for soft tissues, CT for bone lesions—and confirmatory biopsy with histology and genetic testing, since many sarcomas harbor characteristic chromosomal translocations.

Management depends on subtype, size, grade, and stage. Localized disease is usually treated with wide surgical excision and often adjuvant radiotherapy; chemotherapy plays a central role in several subtypes (notably Ewing sarcoma and rhabdomyosarcoma) and in some soft tissue sarcomas. Advanced disease may require systemic therapies, including targeted agents and, in selected cases, immunotherapy. Prognosis varies widely with stage, histology, and treatment response.