What is abdominal liposarcoma. Sarcoma is a sentence. Symptoms of a stomach lesion

Valery Zolotov

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Liposarcoma is a malignant neoplasm that is localized in adipose tissue. This tumor can appear anywhere in the body. It is an irregularly shaped knot of varying density.

This malignant neoplasm can provoke various complications: paresis, paralysis, edema, thrombosis and ischemia. A malignant neoplasm in the retroperitoneal space ranks second in frequency of occurrence.

Causes of the disease

Despite all the achievements of modern medicine, the causes of this disease have not yet been finally clarified. Oncologists have found that liposarcoma can appear from, however, such cases are extremely rare.

Most researchers point to the following reasons:

• hereditary predisposition. First of all, this applies to the closest relatives (parents, sisters and brothers). If they have ever been diagnosed with tumor diseases, then the likelihood of sarcoma increases significantly;
• bad environmental conditions. It's no secret that in the conditions of a modern metropolis we are exposed to the negative influence of various harmful factors. The city air contains a large amount of pesticides that adversely affect our body. First of all, they are carcinogens. These are substances that have a destructive effect on the human genetic code. Such substances include: nickel, arsenic, mercury, lead, asbestos, cobalt and others. The influence of radiation on our body in urban conditions is also not ruled out. Until now, we are experiencing the consequences of the accident at the Chernobyl nuclear power plant, so the total number of cancers in the world has increased;
• work associated with constant contact with harmful chemicals. Despite the fact that at the enterprises associated with the chemical industry, personal protective equipment is provided, workers are, to some extent, exposed to harmful substances. This has an irreparable destructive effect on the human body;
• inflammatory processes and tumor diseases transferred by the patient himself. They mean that a person is already predisposed to the occurrence of any neoplasm;
• bad habits. These include: alcoholism, smoking and drug addiction. All these factors negatively affect the body in all respects and increase the likelihood of sarcoma;
• neglect of a healthy lifestyle. Sedentary work, disruption of sleep and wakefulness, malnutrition, lack of physical activity. All this can lead to the occurrence of most diseases;
• frequent injuries. This risk factor, perhaps more than others, affects the occurrence of sarcoma;
• radiotherapy and corticosteroid treatment.

It's important to know! Almost all of these risk factors are controlled by the person himself. This means that the patient himself can influence the likelihood of sarcoma. Adherence to an active lifestyle alone already has a significant positive impact on human health.

Classification of tumors

1. well-differentiated liposarcoma. Its essential difference is slow growth and absence of metastases. Its structure resembles a lipoma;
2. sclerosing highly differentiated liposarcoma. This malignant neoplasm consists of atypical fat cells that are separated by fibrous layers;
3. inflammatory highly differentiated liposarcoma. In its structure, it resembles one of the above types of tumors. The difference lies in the fact that it has a pronounced lymphoplasmacytic infiltration;
4. myxoid liposarcoma. With this disease, metastases practically do not occur, however, there is a possibility of relapse. It contains mature atypical fat cells. The tumor is characterized by a large number of small vessels. In rare cases, areas with atypical and normal cells are found in tumor tissues. In this case, the prognosis is unfavorable;
5. round cell liposarcoma. It got its name because of the round cells. The number of blood vessels in them is much less than in the area of ​​highly differentiated cells;
6. pleomorphic liposarcoma. It consists of areas with large pleomorphic lipoblasts and a small number of small and rounded lipoblasts;
7. undifferentiated liposarcoma. Its sign is areas with a high degree of differentiation, as well as areas of cells with low differentiation. This tumor resembles pleomorphic fibrosarcoma.

Symptoms

Unfortunately, well-differentiated abdominal liposarcoma usually has no symptoms. Such malignant neoplasms often become an accidental finding during diagnostics associated with other diseases. The initial stage of low-grade liposarcoma is also characterized by an asymptomatic course.

With the further development of the tumor formation, damage to nearby tissues is manifested. In the case when the neoplasm squeezes the nerve endings, severe pain occurs. Another possible symptom is a violation of sensitivity, paralysis, paresis.

MRI liposarcoma of the retroperitoneum

If the tumor squeezes the blood vessels, the disease is complicated by edema and circulatory disorders. Thrombosis and phlebitis that occur during the disease develop under the condition of squeezing the veins by the tumor. In case of arterial compression, ischemia can occur.

It is extremely rare in retroperitoneal liposarcoma of bone tissue lesions. As a rule, this symptom is accompanied by severe pain. With the progression of the disease, symptoms of general intoxication may occur: anemia, asthenic syndrome, exhaustion of the body, fever.

In rare cases, a malignant neoplasm can metastasize to other organs: the liver, organs of the digestive system, bone marrow, kidneys. Unlike a cancerous tumor, abdominal liposarcoma very rarely metastasizes to the lymph nodes.

External manifestations of the tumor in the retroperitoneal space are determined visually and with tactile contact. It is defined as a dense neoplasm with uneven contours and irregular shape. The diameter of the neoplasm can reach 20 centimeters. In rare cases, there are malignant tumors that are divided into sectors. As a rule, the tumor has clear boundaries with surrounding tissues, which gives the impression of a benign formation. However, the sarcoma spreads to the internal tissues and specifically to the muscles.

The diagnosis is established by the doctor on the basis of the patient's complaints, instrumental examination and information obtained during the initial examination. Instrumental studies include:

The doctor can make the final diagnosis of "malignant neoplasm in the retroperitoneal space" only if the possibility of detecting lipoma, cancer, myxoma, chondrosarcoma and other neoplasms is completely excluded.

To cure sarcoma, doctors use a combination of several methods.

It's important to know! If the tumor is of a qualitative nature, and surgical treatment is impossible due to a number of reasons, then the cure is practically impossible, and alternative methods are used to prolong the life of the patient.

Forecast

Compared to other malignant tumors, sarcoma has a relatively favorable prognosis. Survival for 5 years is about 50%. With highly differentiated sarcoma, life expectancy is much higher than the same indicator for other types of malignant neoplasms in the retroperitoneal space. An interesting observation is that adults have a much worse prognosis than children. The five-year survival rate in children is about 85%.

It should be remembered that a malignant oncological formation in the retroperitoneal space is a serious disease that can threaten not only human health, but also his life. For this reason, when the first symptoms appear, it is necessary to visit a medical institution for the purpose of examination.

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Abdominal wall sarcoma

An even less frequent malignant tumor of the abdominal wall is sarcoma, which does not develop from a pigment spot. In many cases, it is caused by scar tissue changes resulting from burns or other injuries. The sarcoma of the abdominal wall often comes from its tendon elements, having at first the appearance of a node. As it grows, it gradually loses its clear contours. Such tumors grow very quickly, are highly malignant, penetrate early into neighboring tissues and metastasize extensively.

Sarcoma of the anterior abdominal wall differs in that it is located superficially and is easily detected during examination. In addition, it is quite clearly defined by touch, especially if you ask the patient to tighten the stomach. Moreover, if you take the abdominal wall into a fold with your fingers and try to move it, then in most cases such tumors move along with the skin fold.

The symptomatology of abdominal wall sarcomas is rather poor, and is mainly limited to a "complex of small signs":

• deterioration in the general condition of the patient;
• weakness;
• sometimes - slight rises in body temperature, etc.

Sarcoma of the retroperitoneum

• their deep localization in the abdominal cavity;
• close contact with its back wall;
• covering the tumor in front of the stomach and intestines;
• limitation of passive and respiratory mobility.

Located near the nerve trunks or roots, tumors put pressure on them, and can even destroy the spine and put pressure directly on the spinal cord. This is manifested by intense pain in the relevant areas, and sometimes by the phenomena of paresis or paralysis. If retroperitoneal sarcoma develops near blood vessels, then it can compress them. The manifestations of such a pathology will depend on the nature of the vessel, the function of which is impaired. For example, pressure on the inferior vena cava is characterized by blueness and swelling of the lower extremities and abdominal walls. Difficulty in the hepatic circulation is manifested by the accumulation of fluid in the abdominal cavity (ascites), etc.

Sarcoma of the stomach

Sarcomas are localized mainly on the body of the stomach. In its inlet and outlet sections, these tumors are much less common. According to the nature of the growth of gastric sarcoma, they are divided into:

• endogastric;
• exogastric;
• intramural or infiltrating;
• mixed.

Exogastric sarcomas originate from the submucosal layer of the stomach, and their growth is directed to the abdominal cavity. Typically, these tumors have a tuberous or lobular shape, and reach a considerable size. Depending on their exact localization, a corresponding clinical picture is observed, due to compression of neighboring organs.

Infiltrating sarcoma is the most common subspecies. It is characterized by rapid growth along the wall of the stomach, sprouting through it over a long distance. Such a sarcoma also often reaches a large size, and often grows into neighboring organs.

Mixed sarcoma grows both in the lumen of the stomach and in the direction of the abdomen. Such tumors grow rather slowly and are characterized by a relatively benign course.

Almost all histological types of sarcomas are found in the stomach:

• lymphosarcomas;
• myosarcomas;
• fibrosarcomas;
• neurosarcomas;
• spindle cell sarcomas, etc.

Symptoms

The scarcity of the initial symptoms of colon sarcomas leads to the fact that they are often diagnosed already at the stage of development of complications in the form of:

• sprouting into neighboring organs (uterus, small intestine, bladder, etc.) with the possible formation of internal fistulas;
• perforation of the intestinal wall into the abdominal cavity with the development of peritonitis, etc.

Sarcoma of the rectum

• fibrosarcomas;
• myosarcomas;
• angiosarcomas;
• liposarcomas;
• lymphosarcomas;
• myxosarcomas, which are composed of several different non-epithelial tissues.

• round cell;
• lymphoreticular;
• reticuloendothelial;
• spindle cells, etc.

The main symptoms of rectal sarcoma are:

• moderate pain;
• pathological discharge from the rectum in the form of mucus with blood, or simply bloody discharge (often in significant quantities);
• disorders of the act of defecation;
• increased urge to defecate;
• feeling of insufficient bowel movement;
• relatively rapidly developing signs of exhaustion of the body.

In the diagnosis of rectal sarcomas, digital examination plays an important role. Tumors that are located more deeply are well detected with colonoscopy and barium enema. Computed tomography is used to confirm the diagnosis of sarcoma. An accurate diagnosis is established only by examining a sample of pathological tissue under a microscope.

Treatment of rectal sarcoma consists in the radical removal of the tumor with part of the intestine, often along with adjacent tissues. The use of chemotherapy and radiation methods of influencing the tumor depends on the sensitivity of its tissues. In advanced stages of the disease, the prognosis is usually poor.

Sarcoma of the liver

Sarcomatous hepatic nodule can reach very large sizes, sometimes even with the head of an adult. In such cases, the liver tissue is subjected to severe compression and subsequent atrophy. Another type of hepatic sarcoma is multiple nodes, which are also associated with a significant increase in the size of the organ.

Secondary liver sarcomas, which develop as a result of metastasis from other organs, are much more common than primary ones. These tumors can also look like a large single nodule, or take the form of multiple nodules that turn the organ into a shapeless mass. Skin melanoma is a common cause of secondary hepatic sarcomas. In this case, the skin lesion can be small and almost invisible, while liver metastases quickly develop to large volumes.

Symptoms of liver sarcoma are in many ways similar to the manifestations of cancer of this organ. However, sarcoma is more common in adolescence. Its clinical signs are nonspecific:

• pain in the right hypochondrium of an indeterminate nature;
• yellowness of the skin;
• elevated body temperature.

The diagnosis of liver sarcoma is established using ultrasound, computed or magnetic resonance imaging, and, if necessary, laparoscopy. Methods of treatment are mainly surgical. With a single node, the affected area is removed, and with multiple nodes or in the case of diffuse tissue damage, surgical treatment is not indicated - radiation and chemotherapy are performed.

Embryonic liver sarcoma

Identification of an embryonic liver tumor most often does not present difficulties even during the initial examination of the patient. Its leading and most striking clinical sign is a significant increase in the volume of the abdomen. Embryonic sarcoma of the liver is almost always easily determined by touch through the anterior abdominal wall. This is due to the fact that such malignant neoplasms are usually quite large, especially in comparison with the size of other abdominal organs and the thickness of the abdominal wall in young children.

Pain in embryonic liver sarcoma is rare. Basically, older children complain of vague diffuse pains in the right hypochondrium. The appearance of such pains, first of all, is associated with the compression of the surrounding organs and tissues by a large tumor. Often there are complaints about:

• a sharp loss of appetite;
• nausea and vomiting that does not bring relief;
• unmotivated increase in body temperature;
• general depletion of the child's body;
• lethargy, weakness and apathy due to intoxication;
• sometimes there are signs of anemia.

Sarcoma of the pancreas

• lymphosarcomas;
• angiosarcomas;
• spindle cell sarcomas.

Clinically, sarcoma practically does not differ from pancreatic cancer. But a non-epithelial tumor is characterized by a faster and more malignant course. In addition, it gives metastases later than cancer.

Early symptoms of pancreatic sarcoma are:

• pain syndrome;
• weight loss and loss of appetite;
• belching, nausea and vomiting that does not bring relief;
• general weakness and malaise;
• the appearance of jaundice;
• increase in body temperature;
• constipation or diarrhea.

The clinical picture of pancreatic sarcoma depends on the location of the tumor. With sarcoma of the head of the pancreas, pain is localized in the right hypochondrium and epigastric region. In most cases, jaundice is observed, and the presence of impurities of fat and protein in the feces is often noted. But thrombosis and disorders of carbohydrate metabolism are uncharacteristic for this situation.

With sarcoma of the tail and body of the pancreas, pain is more often localized in the left hypochondrium and epigastric region. With this location of the tumor, weight loss and dyspeptic symptoms in the form of nausea, belching and vomiting become especially pronounced. In addition, with sarcomas of the body or tail of the pancreas, jaundice is almost always absent. It develops only in the case of transitions of the tumor process to the head of the gland, or in the presence of metastases in the lymph nodes of the liver. But a violation of carbohydrate tolerance or even diabetes mellitus with sarcoma of the body and tail of the gland develops very often. Ascites and enlargement of the spleen are also common. However, impurities of fat in the feces are rare, as well as violations of external secretion.

The most modern and informative methods for diagnosing pancreatic sarcoma are arteriography, scintigraphy, magnetic resonance and computed tomography. To confirm the diagnosis, a puncture biopsy of the affected tissue is performed, followed by its examination under a microscope.

The main treatment for pancreatic sarcomas is surgery. In addition, chemotherapy and radiation therapy are used. In most cases, the prognosis is poor.

Sarcoma of the spleen

• leiomyosarcomas;
• liposarcomas;
• fibrosarcomas;
• osteosarcomas;
• rhabdomyosarcomas;
• myxosarcomas;
• undifferentiated sarcomas.

• progressive weakness;
• anemia
• subfebrile body temperature.

• apathy;
• constant thirst;
• increased amount of urine and frequency of urination;
• loss of appetite;
• nausea and vomiting;
• pain on palpation of the abdomen.

Diagnosis of sarcomas of the spleen is carried out by ultrasound, fluoroscopy, magnetic resonance and computed tomography. The diagnosis is confirmed by puncture biopsy with the collection of pathologically altered tissue and subsequent examination of the sample under a microscope.

Treatment is surgical, including total removal of the spleen. The greatest positive effect is achieved in the early stages of surgical intervention. The later stage of development the disease has, the less favorable the prognosis becomes.

Sarcoma of the kidney

• connective tissue elements of the kidney;
• renal capsule;
• walls of renal vessels, etc.

• round cells;
• spindle cells;
• polymorphic cells.

Hematuria occurs in almost 90% of patients suffering from kidney sarcoma. Blood in the urine appears for no apparent reason, is not accompanied by pain or any functional disorders. Such asymptomatic and painless hematuria is most often very abundant, but it does not last long: 1-2 days. She disappears as suddenly as she appeared. Often, the bleeding is so profuse that even blood clots form in the urine densely saturated with scarlet blood, which can, stuck in the ureter, cause attacks of renal colic. When they accumulate in the bladder, such clots sometimes lead to urinary retention. With sarcomas of the kidneys, blood clots can form, as it were, an internal cast of the ureter, and as a result, they acquire a worm-like shape.

Bleeding in renal sarcoma occurs due to a violation of the integrity of the vessels by a tumor that has sprouted into the pelvis, or congestion in the compressed veins of the kidney.

Palpable neoplasm. Kidney sarcoma grows very quickly, and can reach a significant size without any clinical manifestations. Therefore, in most cases, a tumor that has already increased in volume can be probed during a bimanual examination.

Pain in the kidney area with a malignant non-epithelial tumor is observed in more than half of the cases. Dull pains are caused by the pressure of the sarcoma on neighboring nerve nodes and organs. In addition, similar pain sensations also arise due to the stretching of the connective tissue capsule of the kidney by the tumor, which is very rich in sensitive nerve endings.

If the tumor grows into the nerve pathways, then the pain can spread along them to other systems and organs of the human body. Acute pain syndrome is observed in cases where there is a blockage of the ureter with blood clots or massive hemorrhages occur in the kidney, causing a rapid increase in its volume.

Tumors of the kidney, squeezing or germinating the spermatic vein, are manifested by the expansion of the veins of the spermatic cord and the development of varicocele. In addition, this symptom may also be due to compression of the spermatic vein by lymph nodes affected by metastases of the kidney tumor. With renal sarcoma, varicocele occurs on both the right and left sides, and does not disappear if the patient assumes a horizontal position. Therefore, any dilatation of the veins of the spermatic cord that occurs in middle-aged or elderly men should raise the suspicion of a kidney tumor, and be the reason for an appropriate examination of the patient. The same applies to the unilateral expansion of the saphenous veins of the abdomen or the appearance of the "head of Medusa" (an enlarged venous network around the navel).

The general condition of patients with kidney sarcoma can remain practically undisturbed for a long time. But with the progression of the disease, they begin to grow quite quickly:

• general weakness;
• weight loss, up to the development of exhaustion of the body (cachexia);
• loss of appetite;
• phenomena of anemia.

In the diagnosis of renal sarcomas, X-ray contrast research methods, scintigraphy, ultrasound, magnetic resonance and computed tomography are used. To confirm the diagnosis, a needle biopsy and a study of the obtained tissue sample under a microscope are performed. The only effective treatment is the removal of the affected kidney. And the sooner the operation is performed, the more chances the patient has for a lasting recovery.

Kidney sarcoma in children

Such a tumor is a single, unilateral soft nodule that is clearly demarcated from the surrounding renal tissue. It has a very large size, and its weight can reach 3 kg. Such a sarcomatous node consists of grayish or brownish tissue, and may contain cysts of various diameters.

Clear cell sarcoma of the kidney very early and often metastasizes. First of all, the bone system of the child is affected by metastases. Less commonly, secondary tumor foci develop in regional lymph nodes, the brain, lungs, or liver.

Clear cell sarcoma of the kidney got its name because of the appearance of tumor cells under a microscope. These cells have light nuclei and light cytoplasm. Depending on the predominance of certain histological changes, the following types of this neoplasm are distinguished:

• spindle cell;
• palisade;
• sclerosing;
• sinusoidal (pericytomous);
• anaplastic.

• dyspnea;
• diarrhea or constipation;
• jaundice;

- a group of benign and malignant neoplasms of the serous membrane covering the internal organs and internal walls of the abdominal cavity. Malignant tumors can be both primary and secondary, but are more often metastatic in nature. Benign neoplasms are asymptomatic or are accompanied by signs of compression of nearby organs. Malignant tumors of the peritoneum are manifested by pain and ascites. The diagnosis is made on the basis of complaints, examination data, results of analysis for tumor markers, CT, laparoscopy, immunohistochemical and histological studies. Treatment - surgery, radiation therapy, chemotherapy.

General information

Tumors of the peritoneum - neoplasms of various origins, localized in the visceral and parietal layers of the peritoneum, lesser omentum, greater omentum and mesentery of hollow organs. Benign and primary malignant neoplasms of the peritoneum are rarely diagnosed. Secondary tumors of the peritoneum are a more common pathology; they occur with oncological lesions of the abdominal cavity and retroperitoneal space, internal female and male genital organs. The prognosis for benign lesions is usually favorable, for malignant lesions - unfavorable. Treatment is carried out by specialists in the field of oncology and abdominal surgery.

Classification of tumors of the peritoneum

There are three main groups of neoplasms of the peritoneum:

• Benign tumors of the peritoneum (angiomas, neurofibromas, fibromas, lipomas, lymphangiomas)
• Primary malignant tumors of the peritoneum (mesothelioma)
• Secondary malignant tumors of the peritoneum arising from the spread of malignant cells from another organ.

There are also mucus-forming neoplasms (pseudomyxomas), which some researchers consider as primary, and others as secondary tumors of the peritoneum of varying degrees of malignancy. In most cases, secondary peritoneal lesions develop as a result of aggressive local growth of neoplasms and implantation spread of cancer cells from organs located intraperitoneally, mesoperitoneally, or extraperitoneally.

Tumors of the peritoneum resulting from implantation metastasis can be detected in cancer of the stomach, small and large intestines, liver, pancreas, gallbladder, kidney, uterine body, cervix, ovaries, prostate, anterior abdominal wall, etc. Less commonly there is a lymphogenous spread of metastases of chest tumors (for example, lung cancer), due to the retrograde movement of lymph along the lymphatic pathways.

Types of tumor lesions of the peritoneum

Benign tumors of the peritoneum

They are a very rare pathology. The reasons for the development are unknown. The disease can be asymptomatic for years. In some cases, peritoneal tumors reach enormous sizes, without significantly affecting the patient's condition. The literature describes a case of removal of an omental lipoma weighing 22 kilograms. With large nodes, an increase in the abdomen is detected. Sometimes benign tumors of the peritoneum cause compression of nearby organs. Pain is uncharacteristic. Ascites is extremely rare. The diagnosis is established by the results of laparoscopy. The indication for surgery is the compression effect of the neoplasm on neighboring organs.

Primary malignant tumors of the peritoneum

Peritoneal mesothelioma is rare. Usually found in men over 50 years of age. A risk factor is prolonged exposure to asbestos. Manifested by pain, weight loss and symptoms of compression of nearby organs. With sufficiently large tumors of the peritoneum, an asymmetric protrusion in the abdomen can be detected. On palpation, single or multiple tumor-like formations of various sizes are found.

Rapid progression of symptoms is characteristic. When the portal vein is compressed, ascites develops. Due to the lack of specific signs, the diagnosis of malignant tumors of the peritoneum is difficult. Often, the diagnosis is made only after excision of the neoplasm and subsequent histological examination of the removed tissues. The prognosis is unfavorable. Radical removal is only possible with limited processes. In other cases, patients with peritoneal tumors die from cachexia or from complications caused by dysfunction of the abdominal organs.

Pseudomyxoma of the peritoneum

Occurs when an ovarian cystadenoma, pseudomucinous cyst of the appendix, or intestinal diverticulum ruptures. Mucus-forming epithelial cells spread over the surface of the peritoneum and begin to produce a thick, jelly-like fluid that fills the abdominal cavity. Usually, the rate of development of this peritoneal tumor corresponds to a low degree of malignancy. The disease progresses over several years. The jelly-like fluid gradually causes fibrotic tissue changes. The presence of mucus and tumor formation interferes with the activity of internal organs.

Less commonly, peritoneal tumors of a high degree of malignancy are detected, capable of lymphogenous and hematogenous metastasis. In the absence of treatment in all cases, a fatal outcome occurs. The cause of death of patients is intestinal obstruction, exhaustion and other complications. The presence of a mucus-forming tumor of the peritoneum is evidenced by an increase in the size of the abdomen with a decrease in body weight, digestive disorders and jelly-like discharge from the navel.

The diagnosis is established on the basis of CT, laparoscopy, histological and immunohistochemical studies. For malignant tumors of the peritoneum, positron emission tomography may be used. With a benign variant of the disease, this study is not informative. The tactics of treating peritoneal tumors is determined individually. In some cases, surgical excision of the affected areas is possible in combination with intraperitoneal intracavitary chemotherapy. With the timely start of treatment, the prognosis is quite favorable, especially for low-grade peritoneal tumors.

Solitary secondary malignant tumors of the peritoneum

The lesion occurs during the germination of malignant tumors located in organs partially or completely covered by the peritoneum. The appearance of peritoneal tumors is accompanied by increased pain and worsening of the patient's condition. On palpation of the abdomen, tumor-like formations can be detected. With the collapse of the focus in a hollow organ (stomach, intestines), phenomena of perforated peritonitis are observed. In some cases, the primary tumor simultaneously grows into the wall of the hollow organ, the sheets of the peritoneum and the anterior abdominal wall. With the disintegration of the resulting conglomerate, soft tissue phlegmon occurs.

Tumors of the peritoneum are diagnosed on the basis of anamnesis (there is a malignant neoplasm of the organ covered with the peritoneum), clinical manifestations, ultrasound data of the abdominal cavity and other studies. With a limited process, radical excision of the primary tumor is possible along with the affected area of ​​the peritoneum. In the presence of distant metastases, symptomatic therapy is carried out. Patients with tumors of the peritoneum are prescribed painkillers, with accumulation of fluid in the abdominal cavity, laparocentesis is performed, etc. The prognosis depends on the prevalence of the process.

Peritoneal carcinomatosis

Malignant cells that enter the abdominal cavity quickly spread through the peritoneum and form multiple small foci. At the time of diagnosis of gastric cancer, peritoneal carcinomatosis is detected in 30-40% of patients. In ovarian cancer, secondary tumors of the peritoneum are found in 70% of patients. Pathology is accompanied by the appearance of profuse effusion in the abdominal cavity. Patients are exhausted, weakness, fatigue, stool disorders, nausea and vomiting are detected. Large peritoneal tumors can be palpated through the abdominal wall.

There are three degrees of carcinomatosis: local (one lesion zone is detected), with lesions in several areas (lesions alternate with areas of unchanged peritoneum) and widespread (multiple secondary peritoneal tumors are detected). With an undiagnosed primary tumor and multiple nodes of the peritoneum, clinical diagnosis in some cases is difficult due to the similarity with the picture of tuberculous peritonitis. The hemorrhagic nature of the effusion and the rapid recurrence of ascites after laparocentesis testify in favor of secondary peritoneal tumors.

The diagnosis is established taking into account the anamnesis, clinical manifestations, ultrasound data of the abdominal organs, MSCT of the abdominal cavity with contrast, cytology of ascitic fluid obtained during laparocentesis, and histological examination of a sample of peritoneal tumor tissue taken during laparoscopy. As an additional diagnostic technique, a test for tumor markers can be used, which makes it possible to more accurately determine the prognosis, detect relapses in a timely manner and evaluate the effectiveness of therapy.

If it is possible to completely remove the primary neoplasm and tumors of the peritoneum, radical operations are performed. Depending on the localization of the primary focus, peritonectomy is performed in combination with colectomy, gastric resection or gastrectomy, panhysterectomy and other surgical interventions. Due to the risk of contamination of the abdominal cavity with cancer cells and the possible presence of visually undetectable tumors of the peritoneum during the operation or after it, intraperitoneal hyperthermic chemotherapy is performed. The procedure allows for a powerful local effect on cancer cells with minimal toxic effect of chemotherapy drugs on the patient's body.

Despite the use of new methods of treatment, the prognosis for disseminated secondary peritoneal tumors still remains unfavorable. Carcinomatosis is one of the main causes of death in patients with oncological lesions of the abdominal cavity and small pelvis. The average survival of patients with gastric cancer in combination with peritoneal tumors is about 5 months. Relapses after radical surgical interventions for secondary neoplasms of the peritoneum occur in 34% of patients. Specialists continue to search for new, more effective methods of treating secondary peritoneal tumors. New chemotherapy drugs, immunochemotherapy, radioimmunotherapy, gene antisense therapy, photodynamic therapy and other methods are used.

The content of the article

Etiology of extraorganic retroperitoneal tumors

Pathological anatomy of extraorganic retroperitoneal tumors

Classification of extraorganic retroperitoneal tumors

Clinic of extraorganic retroperitoneal tumors

Diagnosis of extraorganic retroperitoneal tumors

Laboratory research methods

Computed tomography (CT) and magnetic resonance imaging (MRI)

Ultrasound computed tomography

Biopsy

X-ray examination with contrast

Endoscopic research methods

Treatment of extraorganic retroperitoneal tumors

Surgery

Radiation therapy

Recurrence of extraorganic retroperitoneal tumors

Prognosis for extraorganic retroperitoneal tumors

One of the dangerous formations is considered to be a sarcoma, which will be discussed.

What is this disease?

Sarcoma is a malignant tumor process that originates from connective tissue cellular structures.

Localization

This type of tumor does not have any strict localization, since connective tissue elements are present in all structures of the body, so sarcomas can occur in any organ.

In the photo you can see what the initial stage of Kaposi's sarcoma looks like

The danger of sarcoma is also that this tumor in a third of cases affects young patients under 30 years old.

Classification

Sarcoma has many classifications. According to the origin of the sarcoma are divided:

• On tumors originating from hard tissues;
• From soft tissue structures.

According to the degree of malignancy, sarcomas are divided into:

1. Highly malignant - rapid division and growth of tumor cell structures, few stroma, widely developed vascular system of the tumor;
2. With low malignancy - cell division occurs with low activity, they are perfectly differentiated, the content of tumor cells is relatively low, there are few vessels in the tumor, and stroma, on the contrary, there are many.

Depending on the tissue type, sarcomas are classified into osteosarcomas, reticulosarcomas, chondrosarcomas, cystosarcomas, liposarcomas, etc.

According to the degree of differentiation, sarcomas are divided into several varieties:

• GX - it is impossible to determine the differentiation of cellular structures;
• G1 - highly differentiated sarcoma;
• G2 - moderately differentiated sarcoma;
• G3 - poorly differentiated sarcoma;
• G4 - undifferentiated sarcomas.

Cell differentiation involves determining the type of cells, the type of tissue to which they belong, etc. With a decrease in cell differentiation, the malignancy of the sarcoma increases.

With the growth of malignancy, the tumor begins to grow intensively, which leads to increased infiltrativity and even faster development of the tumor process.

Causes of the disease

The exact causes of sarcomas have not been established, however, scientists have established a connection between some factors and the tumor.

1. Heredity, genetic conditioning, the presence of chromosomal pathologies;
2. Ionizing radiation;
3. Carcinogenic influence like cobalt, nickel or asbestos;
4. Abuse of ultraviolet radiation with frequent visits to the solarium or prolonged exposure to the scorching sun;
5. Viruses like papillomavirus, herpesvirus, HIV, or Epstein-Barr virus;
6. Harmful industries associated with the chemical industry or oil refining;
7. Immune failures that cause the development of autoimmune pathologies;
8. The presence of precancerous or benign processes;
9. Long-term nicotine dependence;
10. Hormonal disruptions in the process of puberty, which lead to intensive growth of bone structures.

Such factors cause uncontrolled division of cellular connective tissue structures. As a result, abnormal cells form a tumor and grow into neighboring organs and destroy them.

Symptoms of sarcoma of various organs

Clinical manifestations of sarcoma differ in accordance with the specific form of the tumor, its localization, and the degree of development of the sarcoma.

At the first stage of the tumor process, a rapidly progressive formation is usually detected, but with its development, neighboring structures are also involved in the tumor process.

Abdomen

Sarcomas that form in the abdominal cavity have symptoms similar to cancer. Abdominal sarcomas develop in the tissues of various organs.

• Liver. It is rare, manifested by painful symptoms in the right hypochondrium. Patients noticeably lose weight, the skin becomes icteric, in the evenings hyperthermia worries;
• Stomach. It is characterized by a long asymptomatic onset. Often discovered by chance. Patients note the appearance of dyspeptic disorders such as nausea, heaviness, flatulence and bloating, rumbling, etc. Gradually, signs of exhaustion increase, the patient constantly feels tired, weakened, depressed and irritable;
• Intestine. Such sarcomas are accompanied by pain in the abdomen, weight loss, nausea and belching, lack of appetite, frequent diarrhea, bloody-mucous discharge from the intestine, frequent bowel movements, rapid depletion of the body;
• Kidneys. Sarcoma in the renal tissues is characterized by pronounced hematuria, soreness in the area of ​​​​the location of the formation, with palpation the tumor can be felt. Blood in the urine does not cause any other discomfort or urinary problems;
• Retroperitoneal space. Most often, the sarcoma grows to a significant size, squeezing neighboring tissues. The tumor can destroy the nerve roots, vertebral elements, which is accompanied by intense pain in the corresponding areas. Sometimes such a sarcoma causes paralysis or paresis. When the tumor compresses the blood vessels, swelling of the extremities and abdominal walls may occur. If the hepatic circulation is disturbed, then ascites develops, etc.
• Spleen. In the early stages of development, the sarcoma does not manifest itself in any way, but with the growth of education, the organ increases, then the tumor begins to disintegrate, which is accompanied by a clinic of intoxication such as subfebrile temperature, anemia and progressive weakness. Also, splenic sarcoma is characterized by a constant feeling of thirst, lack of appetite, apathy, nausea and vomiting, frequent urge to urinate, pain, etc.;
• Pancreas. Such a sarcoma tumor is characterized by pain, hyperthermia, weight loss, loss of appetite, diarrhea or constipation, jaundice, malaise and general weakness, nausea and vomiting symptoms, belching, etc.

As can be seen, sarcomas of organs located in the abdominal cavity are often accompanied by similar symptoms.

The organs of the chest

Tumors of similar localization most often arise as a result of metastasis from other foci. Symptoms vary depending on location.

1. Rib sarcoma. At first, the patient feels pain in the region of the ribs, chest and surrounding tissues, gradually the pains increase, soon even anesthetics cannot cope with them. A swelling is felt on the ribs, which, when pressed, causes pain. The patient is disturbed by symptoms such as irritability, excessive excitability, anxiety, anemia, fever, local hyperthermia, respiratory disorders.
2. Lungs. Such formations are indicated by a symptom such as excessive fatigue, shortness of breath, dysphagia (with metastasis to the esophagus), nausea and vomiting symptoms, hoarseness, pleurisy, cold symptoms, prolonged pneumonia, etc.
3. Heart and pericardium. The tumor manifests itself with slight hyperthermia, weight loss, joint pain and general organic weakness. Then rashes appear on the body and limbs, a clinical picture of heart failure develops. Patients have swelling of the face and upper limbs. If the sarcoma is localized in the pericardium, then the symptoms suggest the presence of hemorrhagic effusion and tamponade.
4. Esophagus. Symptoms of esophageal sarcoma are based on violations of swallowing processes and pain. Pain symptoms are concentrated behind the sternum, but can radiate to the vertebral regions and the scapular region. There is always inflammation of the esophageal walls. As in other cases, sarcoma is accompanied by anemia, weakness and weight loss. Such a pathology ultimately leads to the complete exhaustion of the patient.
5. Mediastinum. The tumor spreads to all tissues of the mediastinum and squeezing and growing into the organs located in it. When the tumor penetrates into the pleura, exudate appears in its cavities.

Spine

Sarcoma of the spine is a tumor malignant formation in the spinal tissues and adjacent structures. The danger of pathology in compression or damage to the spinal cord or its roots.

Symptoms of vertebral sarcoma are determined by its localization, for example, in the cervical, thoracic, lumbosacral, or ponytail.

However, all lumbar tumors have common features:

• Rapid tumor development (in a year or less);
• In the department affected by the tumor, pain is felt, which is characterized by a constant character, which is not eliminated by anesthetics. Although at first it is weakly expressed;
• Limited mobility of the affected vertebrae, forcing patients to take a forced position;
• Complications of a neurological nature in the form of paresis, paralysis, dysfunction of the pelvis, which are among the first to manifest themselves;
• The general condition of the patient with vertebral sarcoma is assessed by doctors as severe.

Brain

The main symptoms of cerebral sarcoma are:

1. unexplained headaches;
2. Frequent dizziness with loss of consciousness, movements become uncoordinated, vomiting is often disturbing;
3. Behavioral disorders, mental disorders;
4. Frequent cases of epileptic seizures;
5. Temporary visual disturbances, however, against the background of constantly elevated ICP, there is a high risk of developing optic nerve atrophy;
6. The development of partial or complete paralysis.

Ovary

Ovarian sarcoma is characterized by large size and rapid growth, poor symptoms such as nagging pain, heaviness in the lower abdomen, menstrual disorders, and sometimes ascites. Sarcoma is often bilateral and has a very rapid development.

Eyes

Primary sarcomas usually form in the upper parts of the orbit, and this form is more common in children.

Such tumors grow rapidly, increasing their size. There is swelling and pain in the eye socket. The eyeball is limited in mobility and shifts, exophthalmos develops.

Blood and lymph

The clinical picture of lymphosarcoma depends on the primary focus, more precisely, its localization. Lymphosarcomas are most often B-cell in nature and are similar in course to acute leukemia.

Larynx

Laryngeal sarcoma is accompanied by difficulty in swallowing, the voice becomes hoarse, if the tumor is localized under the ligaments, then a pathological narrowing of the esophagus and airways occurs.

Prostate

Prostate sarcoma is characterized by aggressive and rapid development, and it begins to show characteristic manifestations when it reaches a significant size or when it metastasizes to neighboring structures.

Symptoms: increased frequency and difficulty in urination, intense pain in the lower abdomen and anus, hyperthermia, rapid weight loss and rapid exhaustion of the body.

Sarcoma formations have a fairly abundant variety of forms, each of which has its own characteristics and differences.

• Stromal sarcoma

A similar form of the tumor process is most often characteristic of the endometrium and develops in the uterus. The main cause of this disease is the exposure to which the woman was once exposed.

In addition, frequent gynecological curettages, abortions and birth injuries, endometriosis and polyposis can cause stromal sarcoma. Manifested by bleeding and pain symptoms.

Such a tumor consists of spindle-shaped cell structures. It is often confused with fibroma.

Spindle cell sarcoma nodules are densely fibrous and prefer skin, mucosal tissues, fascia, and serosa.

If such a sarcoma is detected at an early stage, then the patient has a chance for favorable prognosis.

It belongs to soft tissue formations, it is characterized by high recurrence (more than 40%), hepatic, pulmonary and cerebral metastasis by the lymphogenous route. Such formations are localized mainly deep in muscle tissues. The onset of development is asymptomatic, which makes early diagnosis difficult.

Such a sarcoma is most often found in the limbs, less often on the trunk. A similar tumor is detected when it grows to a large size (more than 10 cm).

It is a nodular, dense formation with a lobed structure containing areas of hemorrhages of dead tissues. Often, patients die within the first 12 months of detection of pleomorphic sarcoma, which is characterized by a low survival rate of no more than 10%.

This is a primary cutaneous sarcoma that develops along the soft tissue periphery. In the process of growth, such sarcomas ulcerate, metastasize by the lymphogenous route, accompanied by a characteristic growth of the spleen. Amenable only to surgical treatment.

This is an education that is impossible or too difficult to attribute to any class or type. These sarcomas are not associated with any specific cellular structures, but are treated similarly to rhabdomyosarcomas.

Such a formation contains polymorphic cellular structures. The tumor is characterized by an unfavorable prognosis, as it quickly generalizes. Such a sarcoma is characterized by an aggressive course and a negative reaction to the therapeutic effect. Pathology often affects the gastrointestinal tract, skin and soft tissue structures.

Such a sarcoma consists of round cell structures, develops rapidly and belongs to high-grade tumors. Affects soft tissue and skin structures.

This tumor has a low malignancy. Affects patients regardless of age. It is localized mainly on the hips, shoulders, torso. Such formations usually grow rather slowly and practically do not metastasize.

Such a tumor affects the immune structures and is characterized by polymorphic symptoms. It is characterized by an increase in lymph nodes, autoimmune anemia, eczema-like skin lesions. The tumor compresses the vessels of the circulatory and lymphatic systems, which provokes the development of necrosis.

Such sarcomas mainly affect the extremities, and more often in young patients. Such a tumor is considered a type of synovial sarcoma.

A local tumor consisting of myeloblasts of the leukemic type. It is localized most often in cranial bones, lymph nodes, intraorganic structures, spongy or tubular bone tissues, etc.

Fastiogenic formation, most often located in the neck, head, torso and affects the soft tissue structures. Such a tumor develops slowly and for a long time, relapses and metastasis often occur.

It is formed mainly on the legs, develops slowly, contains spindle-shaped cells, differs in delimitation from other tissues. The treatment of such a tumor is only surgical, but the prognosis is favorable. The survival rate is about 80%.

Difference from cancer

Sarcoma differs from cancer in its connective tissue origin, while cancers are formed from ectodermal and epithelial cell structures.

Such a tumor occurs wherever there are connective tissue cells.

Stages of the malignant process

Sarcoma develops in stages:

• At the first stage, the tumor exists limitedly in the tissues of a certain organ from which it began to form;
• At the second stage, the sarcoma begins to grow into the internal structures of the organ, disrupting its functionality, the tumor increases markedly, but no metastasis is observed;
• At the third stage, the sarcoma grows into the fascia and neighboring tissues, regional lymph nodes;
• At stage 4, the patient expects the most unfavorable prognosis. The tumor reaches a large size, strongly presses on neighboring structures and actively metastasizes.

Metastases

A similar phenomenon in sarcoma tumors is a secondary formation of tumor foci. Malignant cells break off and penetrate into the lymph or bloodstream.

With blood, abnormal cellular structures ply through the systems of the body. When they stop in a place they like, a metastasis is formed.

Diagnostics

Diagnostic measures involve standard procedures such as:

• MRI or CT;
• Radiography;
• Radionuclide research
• Neurovascular or morphological diagnostics;
• Biopsies, etc.

How to treat sarcoma?

Treatment of sarcoma is predominantly surgical with additional chemotherapy or radiation. It is the combined treatment that provides maximum effectiveness.

This approach contributes to an increase in survival up to 70% of cases. Since the tumor is sensitive to radiation, such a technique necessarily complements surgical removal.

Prognosis and survival

Forecasts for sarcoma are determined by the stage of the tumor process, its shape and localization, the presence of metastases, etc.

For example, gastric sarcoma in a third of cases is characterized by early metastasis, which negatively affects the prognosis. Retroperitoneal sarcoma is difficult to predict, because it has a lot of options for the clinical course with different outcomes.

More accurate predictions of survival depend on the specific type of sarcoma, each of which requires an individual approach. Of no small importance is the response to treatment, the condition of the patient and other factors.

Sarcoma

Sarcoma is a name that unites oncological tumors of a large group. Different types of connective tissue under certain conditions begin to undergo histological and morphological changes. Then the primary connective cells begin to grow rapidly, especially in children. A tumor develops from such a cell: benign or malignant with elements of muscles, tendons, and blood vessels.

Connective tissue cells divide uncontrollably, the tumor grows and without clear boundaries passes into the territory of healthy tissue. 15% of neoplasms become malignant, the cells of which are carried by blood throughout the body. As a result of metastasis, secondary growing oncoprocesses are formed, therefore it is believed that sarcoma is a disease that is characterized by frequent relapses. In terms of lethal outcomes, it occupies the second position among all oncological formations.

Is sarcoma cancer or not?

Some of the symptoms of sarcoma are the same as those of cancer. For example, it also grows infiltratively, destroys neighboring tissues, recurs after surgery, metastasizes early and spreads to organ tissues.

How is cancer different from sarcoma?

• cancer tumor has the appearance of a bumpy conglomerate, rapidly growing without symptoms in the early stages. Sarcoma is pinkish, reminiscent of fish meat;
• epithelial tissue is affected by a cancerous tumor, muscular connective tissue is affected by sarcoma;
• cancer develops gradually in any particular organ in people after 40 years of age. Sarcoma is a disease of young people and children, it instantly affects their organisms, but is not tied to any one organ;
• cancer is easier to diagnose, which increases the rate of its cure. Sarcoma is more often detected at stages 3-4, so its mortality is 50% higher.

Is sarcoma contagious?

No, she's not contagious. A contagious disease develops from a real substrate that carries the infection by airborne droplets or through the blood. Then a disease, such as influenza, can develop in the body of a new host. Sarcoma can get sick as a result of changes in the genetic code, chromosomal changes. Therefore, patients with sarcoma often have close relatives who have already been treated for any of its 100 types.

HIV sarcoma is a multiple hemorrhagic sarcomatosis called "angiosarcoma" or "Kaposi's sarcoma". It is recognized by ulceration of the skin and mucous membranes. A person becomes ill as a result of herpes infection of the eighth type through the lymph, blood, secretions of the secretion of the skin and saliva of the patient, as well as through sexual contact. Even with antiviral therapy, Kaposi's tumor often recurs.

The development of sarcoma on the background of HIV is possible with a sharp decrease in immunity. At the same time, AIDS or a disease such as lymphosarcoma, leukemia, lymphogranulomatosis, or multiple myeloma can be detected in patients.

Causes of sarcomas

Despite the variety of types, sarcoma is rare, only in the amount of 1% of all oncological formations. The causes of sarcoma are varied. Among the established causes are: exposure to ultraviolet (ionizing) radiation, radiation. And also risk factors are viruses and chemicals, harbingers of the disease, benign neoplasms that turn into oncological ones.

The causes of Ewing's sarcoma may be in the rate of bone growth and hormonal levels. Important risk factors such as smoking, work in chemical industries, contact with chemicals. Most often, oncology of this type is diagnosed due to the following risk factors:

• hereditary predisposition and genetic syndromes: Werner, Gardner, multiple basal cell pigmented skin cancer, neurofibromatosis or retinoblastoma;
• herpes virus;
• lymphostasis of the legs in a chronic form, the recurrence of which occurred after a radial mastectomy;
• injuries, wounds with suppuration, exposure to cutting and piercing objects (shards of glass, metal, wood chips, etc.);
• immunosuppressive and polychemotherapy (in 10%);
• organ transplant operations (in 75% of cases).

Informative video

General symptoms and signs of the disease

Signs of sarcoma appear depending on its location in the vital organs. The biological characteristics of the root cause of the cell and the tumor itself affect the nature of the symptoms. An early sign of a sarcoma is the noticeable size of the lesion as it grows rapidly. Pain in the joints and bones appears early (especially at night), which is not relieved by analgesics.

For example, due to the growth of rhabdominosarcoma, the oncoprocess spreads to the tissues of healthy organs and manifests itself in various pain symptoms and hematogenous metastasis. If sarcoma develops slowly, signs of the disease may not appear for several years.

Symptoms of lymphoid sarcoma are reduced to the formation of oval or round nodes and small swelling in the lymph node. But even with sizes of 2-30 cm, a person may not feel pain at all.

In other types of tumors with rapid growth and progression, fever, veins under the skin, and cyanotic ulcerations on them, may appear. On palpation of the formation, it is revealed that it is limited in mobility. The first signs of sarcoma are sometimes characterized by deformation of the joints of the extremities.

Liposarcomas, along with other types, can be of a primary multiple nature with sequential or simultaneous manifestation in different areas of the body. This significantly complicates the search for a primary tumor that metastasizes.

Symptoms of sarcoma, located in soft tissues, are expressed in painful sensations on palpation. Such a tumor has no outline, and it quickly penetrates into the tissues nearby.

With a pulmonary oncological process, the patient suffers from shortness of breath, which causes oxygen starvation of the brain, pneumonia, pleurisy, dysphagia may begin, and the right sections of the heart may increase. Outwardly, lung sarcoma can manifest itself as a violation of the endocrine glands, and at the same time:

• the bones of the limbs thicken;
• the top layer of bones becomes inflamed;
• pain in the joints appears.

If the tumor compresses the superior vena cava, then there is a violation of the outflow from the vein, which collects blood from the upper parts of the body. Therefore, the patient:

• swelling of the face;
• the skin becomes pale with a bluish tint;
• superficial veins of the face, neck and upper torso expand;
• nosebleeds occur.

With lymphosarcomas, the patient weakens, working capacity decreases. His temperature rises and sweating, the blood changes, as red blood cells and platelets are destroyed. The skin becomes pale and with the presence of pinpoint hemorrhages on it and mucous membranes. Rashes in the form of small bubbles are possible with allergic reactions to toxins that circulate in the blood.

• tonsils of the pharynx, LU of the neck and above the clavicle - the LU and tonsils increase and thicken, the voice changes, it becomes nasal, discharge from the nasal cavity appears, itching and an allergic reaction of the skin in the area of ​​the LU of the neck and conglomerates that do not cause pain;
• mediastinum (sternum) - characteristic manifestations of shortness of breath with a dry paroxysmal cough, wheezing, high body temperature. Again, the skin of the face turns pale, and the lips become blue;
• in the kidney area - the ureter is compressed and urine stagnates in the pelvis, then urination becomes painful and the lower back hurts;
• in the LU of the mesentery and behind the peritoneum - the patient loses weight dramatically due to profuse diarrhea, ascites appears (fluid accumulates in the peritoneum), intestinal obstruction, if the tumor is large, the spleen also enlarges.

With skin sarcoma, many elements appear on the mucous membranes and skin: asymmetrically located and painless purple spots and nodules in young people, in the elderly - brown, purple or brown, with a diameter of 2-5 mm. The boundaries of the formations are irregular, but clear. They have a smooth or bumpy surface, slightly protruding above healthy areas of the skin. The surface can ulcerate, bleed with injuries, as new vessels form in the tumor, prone to fragility and rupture. Skin oncoprocess is more often localized on the hands, feet, legs in case of circulatory disorders and a decrease in local immunity. Atypical cells in these areas are difficult to destroy. The patient may complain of burning itching, as an allergic reaction to the waste products of the tumor occurs.

Sarcoma in children and adolescents

Since the connective and muscle tissues are actively growing, sarcoma in children progresses rapidly and often recurs. It is on the second step after cancer among the number of oncological formations, which lead to death.

Diagnose the following main types of sarcomas in children:

• acute leukemia of the bone marrow and circulatory system;
• lymphosarcoma or lymphogranulomatosis of the central nervous system;
• osteosarcoma;
• soft tissue sarcoma or major vital organs.

Signs of sarcoma in children appear due to genetic predisposition and heredity, mutations in the child's body, injuries and injuries, past diseases and a weakened immune system.

Symptoms of soft tissue sarcoma in children are manifested in connection with the location of the oncological process. Namely:

• with a superficial location, puffiness is visually noticeable, prone to increase. It hurts, which disrupts the functional work of the body. If there was an injury, then the mobility of the limbs is limited;
• when located in the orbit area, at first the eyeball will bulge outward without pain, the eyelids will swell. Later, pain will appear and vision will be impaired due to compression of the tissues of the eye;
• when located in the nasal cavity, a runny nose appears, the nose will be constantly blocked;
• at the base of the skull, the formation disrupts the function of the nerves of the brain, which often causes double vision or paralysis of the nerve of the face;
• oncoprocess in the urinary tract and genital organs with large tumors disrupts general well-being, manifests itself as constipation and / or impaired urine output, vaginal bleeding, blood in the urine and pain.

Osteosarcoma (osteogenic sarcoma) is a severe oncological disease that occurs most often in young people. It can be osteolytic, osteoplastic, mixed, and malignantly produces bone tissue. In an osteolytic focus that destroys bone tissue, it is solitary and diffuse and tends to increase along the length of the bone and capture the entire width. It can destroy the cortical layer of the bone, damage the medullary canal, nearby soft tissues, and spread metastases throughout the body via the hematogenous route.

Osteoplastic sarcoma grows, spreading through the voids of the spongy layer of the bone and forming growths in the form of needles or a fan. It destroys the bone less and more often occurs in the jaw area, causing irreversible morphological changes in the affected areas of the body and face. The mixed form of sarcoma includes the simultaneous formation of a tumor, and the destruction of bone tissue.

It is difficult to determine the initial stage of osteosarcoma by unclear dull pains near the joints, especially when the formation is localized in the tubular bone. Pain occurs more often at night than during the day. They intensify only after the breakthrough of the tumor mass through the bone cortical layer and spread to nearby tissues. Perhaps a thickening of the extra-articular bone, a manifestation of a sclerotic venous network on the skin. On palpation there is a sharp cutting pain. Severe pain at night may not be related to the location of the tumor, they cannot be relieved with analgesics.

In addition to osteosarcoma, bone tissue is affected by:

Lymphosarcoma affects the lymphatic tissues, proceeds more like acute leukemia than lymphogranulomatosis. The first symptoms of lymphosarcoma appear with pain in the area:

• peritoneum due to intestinal obstruction (manifest early), an increase in the volume of the abdomen (manifest late);
• lymph nodes of the sternum (mediastinum): symptoms are manifested by high fever, cough and malaise, as in viral and inflammatory diseases, later - shortness of breath, varicose veins under the skin of the chest wall;
• nasopharynx due to inflammation, later - swelling of the face;
• lymph nodes of the neck, groin, armpits and their increase.

With lymphogranulomatosis in a child, a painless lymph node, prone to enlargement, can first be found on the neck. Less often, nodes are found in the sternum, groin or under the armpits. Very rarely - in the stomach, spleen, lungs, intestines, bones and bone marrow.

The abdominal form of granulomatosis is characterized by lesions of the retroperitoneal lymph nodes that do not cause pain on palpation. They are inactive, gradually thicken, but do not fully solder with the skin. With damage to the spleen, which happens often, the body temperature rises. The fever intensifies and cannot be controlled with antibiotics, analgin and aspirin. In this case, there is increased sweating, especially at night, but without chills. The child will complain of itchy skin and headache, palpitations and stiffness of the joints and muscles. He weakens and loses his appetite, a manifestation of hepatolienal syndrome is possible. With a decrease in immunity, lymphogranulomatosis is accompanied by bacterial and viral infections. The terminal form of granulomatosis is manifested by a violation of the functions of the respiratory, cardiovascular and nervous systems.

With the most common type of sarcoma - acute leukemia: lymphoblastic or myeloid, the first general symptoms appear:

• deterioration in general well-being: fatigue, drowsiness, unwillingness to move and do something;
• sudden weight loss and loss of appetite;
• heaviness in the abdomen, especially on the left, which is not related to the calorie or fat content of the food;
• susceptibility to infectious diseases;
• fever and body sweating.

Of the nonspecific symptoms, a sharp drop in erythrocytes in the blood is noted due to the displacement of healthy bone marrow cells by cancer cells. At the same time, the level of platelets and leukocytes decreases, which disrupts their functional work. Anemia occurs, and with anemia - shortness of breath, fatigue, and the skin becomes pale, bruising, bleeding gums, and blood is discharged from the nose.

When other organs are affected by leukemia, their activity is disrupted, and there are:

• headache;
• general weakness;
• convulsions and vomiting;
• pain in bones and joints;
• gait disturbances during movement;
• visual disturbances;
• pain, swelling of the gums and a rash on their surface;
• breathing problems with an increase in the size of the thymus gland;
• puffiness on the face and hands, which indicates a failure of the blood supply to the brain.

Informative video

Classification, species, type and forms

Two large groups are bone and soft tissue sarcomas. Oncoprocess affects organs inside the body, skin, central and peripheral nervous system, lymphoid tissue.

The classification of sarcomas according to the ICD-10 code includes:

• C45 - mesothelioma;
• C46 - Kaposi's sarcoma;
• C47 - oncological formation of peripheral nerves and the autonomic nervous system;
• C48 - oncology of the peritoneum and retroperitoneal space;
• C49 - malignant tumors of soft and connective tissue of another type.

Mesothelioma, growing from the mesothelium, affects the pleura, peritoneum and pericardium. Kaposi's sarcoma affects the blood vessels, which manifests itself on the skin as red-brown spots with pronounced edges. An aggressive tumor is extremely dangerous for human life.

With damage to the nerves: peripheral and autonomic oncoprocess develops in the lower extremities, head, neck, chest, pelvis and thighs. Sarcoma of internal organs and soft tissues in the peritoneum and retroperitoneal space causes their thickening. Cancer formations of other types affect soft tissues in any sector of the body, provoking the growth of secondary sarcoma.

Histological classification

The type of sarcoma tissue affects their classification, therefore they are called:

• osteosarcoma - oncological formation of bone tissue;
• mesenchymoma - an embryonic tumor;
• liposarcoma - a neoplasm of adipose tissue;
• angiosarcoma - oncotumor of blood and lymph vessels;
• myosarcoma - formations from muscle tissue and other types.

Lymphosarcoma from lymphoid tissue contributes to poor quality: lymphoblastic or lymphocytic degeneration and growth of the lymphatic system: lymph glands of the large intestine, tongue, pharyngeal ring, lymph nodes and others. The components of the lymphatic vessels during growth form lymphangiosarcoma.

Chondrosarcoma develops from the cartilaginous tissue, parosteal tumor develops from the tissues surrounding the bone and periosteum. The growth of reticulosarcoma occurs from the cells of the bone marrow, Younging's sarcoma - from the tissues of the terminal sections of the long bones of the legs and arms.

Connecting elements and fibrous fibers give rise to fibrosarcoma, stromal connective tissues in any organ give rise to stromal oncology of the gastrointestinal tract and these organs. In the elements of striated muscles, rhabdomyosarcoma develops, in the growths of skin vessels and lymphoid tissue with a decrease in immunity - Kaposi's sarcoma, in skin structures and connective tissue - dermatofibrosarcoma, in the synovial membranes of the joints - a synovial tumor.

The cells of the nerve sheaths degenerate into neurofibrosarcoma, connective tissue cells and fibers - into fibrous histiocytoma. Spindle cell sarcoma, consisting of large cells, affects the mucous membranes. Mesothelioma grows from the mesothelium of the pleura, peritoneum and pericardium.

Types of sarcomas by location

Types of sarcoma are distinguished depending on the location. Of the 100 species, sarcomas most often develop in the area:

• peritoneum and retroperitoneal space;
• neck, head and bones;
• mammary glands and uterus;
• stomach and intestines (stromal tumors);
• fatty and soft tissues of the limbs and trunk, including desmoid fibromatosis.

New oncological formations in adipose and soft tissues are especially often diagnosed:

• liposarcoma, developing from adipose tissue;
• fibrosarcoma, which refers to fibroblastic/myofibroblastic formations;
• fibrohistiocytic soft tissue tumors: plexiform and giant cell;
• leiomyosarcoma - from smooth muscle tissue;
• glomus oncotumor (pericytic or perivascular);
• rhabdomyosarcoma from the musculature of the skeleton;
• angiosarcoma and epithelioid hemangioepithelioma, which are related to vascular formations of soft tissues;
• mesenchymal chondrosarcoma, extraskeletal osteosarcoma - bone and cartilage tumors;
• malignant SM of the gastrointestinal tract (stromal tumor of the gastrointestinal tract);
• tumor formation of the nerve trunk: peripheral nerve trunk, newt tumor, granular cell tumor, ectomesenchymoma;
• sarcomas of unclear differentiation: synovial, epithelioid, alveolar, clear cell, Ewing, desmoplastic round cell, intimal, PEComu;
• undifferentiated / unclassified sarcoma: spindle cell, pleomorphic, round cell, epithelioid.

From bone oncological formations according to the WHO classification (ICD-10), the following tumors are often found:

• cartilage tissue - chondrosarcoma: central, primary or secondary, peripheral (periosteal), clear cell, dedifferentiated and mesenchymal;
• bone tissue - osteosarcoma, an ordinary tumor: chondroblastic, fibroblastic, osteoblastic, as well as telangiectatic, small cell, central low degree of malignancy, secondary and paraosteal, periosteal and superficial high degree of malignancy;
• fibrous tumors - fibrosarcoma;
• fibrohistiocytic formations - malignant fibrous histiocytoma;
• Ewing's sarcoma / PNET;
• hematopoietic tissue - plasmacytoma (myeloma), malignant lymphoma;
• giant cell: malignant giant cell;
• tumor formation of the chord - "Dedifferentiated" (sarcomatoid) chordoma;
• vascular tumors - angiosarcoma;
• smooth muscle tumors - leiomyosarcoma;
• adipose tissue tumors - liposarcoma.

The maturity of all types of sarcomas can be low, medium and highly differentiated. The lower the differentiation, the more aggressive the sarcoma. The treatment and prognosis of survival depends on the maturity and stage of education.

Stages and degrees of the malignant process

There are three degrees of malignancy of sarcoma:

1. Poorly differentiated degree, in which the tumor consists of more mature cells and the process of their division is slow. It is dominated by stroma - normal connective tissue with a small percentage of oncoelements. Education rarely metastasizes and recurs little, but can grow to large sizes.
2. A highly differentiated degree in which tumor cells divide rapidly and uncontrollably. With rapid growth, a dense vascular network with a large number of high-grade cancer cells forms in the sarcoma, and metastases spread early. Surgical treatment of a high-grade mass may be ineffective.
3. A moderately differentiated degree, in which the tumor has an intermediate development, and with adequate treatment, a positive prognosis is possible.

The stages of sarcoma do not depend on its histological type, but on the location. More determines the stage according to the state of the organ where the tumor began to develop.

The initial stage of sarcoma is characterized by small size. It does not extend beyond those organs or segments where it originally appeared. There are no violations of the working functions of organs, compression, metastasis. Virtually no pain. If a highly differentiated stage 1 sarcoma is detected, positive results are achieved with complex treatment.

Signs of the initial stage of sarcoma, depending on the location in a particular organ, for example, are as follows:

• in the oral cavity and on the tongue - a small node up to 1 cm in size and with clear boundaries appears in the submucosal layer or mucous membrane;
• on the lips - the node is felt in the submucosal layer or inside the tissue of the lip;
• in the cellular spaces and soft tissues of the neck - the size of the node reaches 2 cm, it is located in the fascia, limiting its location, and does not go beyond them;
• in the larynx area - the mucous membrane or other layers of the larynx limit the node, up to 1 cm in size. It is located in the fascial case, does not go beyond it and does not disturb phonation and breathing;
• in the thyroid gland - a node up to 1 cm in size is located inside its tissues, the capsule does not germinate;
• in the mammary gland - a node up to 2-3 cm grows in a lobule and does not go beyond its limits;
• in the area of ​​the esophagus - the onconode up to 1-2 cm is located in its wall, without disturbing the passage of food;
• in the lung - manifested by the defeat of one of the segments of the bronchi, without going beyond it and without violating the working function of the lung;
• in the testicle - a small node develops without involvement of the albuginea in the process;
• in the soft tissues of the extremities - the tumor reaches 5 cm, but is located within the sheaths of the fascia.

Stage 2 sarcoma is located inside the organ, germinates all layers, disrupts the functional work of the organ with an increase in size, but there is no metastasis. The oncoprocess manifests itself as follows:

• in the oral cavity and on the tongue - a noticeable growth in the thickness of the tissues, the germination of all membranes, mucous membranes and fascia;
• on the lips - germination of the skin and mucous membranes;
• in cellular spaces and soft tissues of the neck - up to 3-5 cm in height, beyond the fascia;
• in the region of the larynx - the growth of the node is more than 1 cm, the germination of all layers, which disrupts phonation and respiration;
• in the thyroid gland - the growth of the node is more than 2 cm and the involvement of the capsule in the oncological process;
• in the mammary gland - the growth of the node up to 5 cm and the germination of several segments;
• in the esophagus - the germination of the entire thickness of the wall, including the mucous and serous layers, the involvement of the fascia, severe dysphagia (difficulty swallowing);
• in the lungs - compression of the bronchi or spread to the nearest pulmonary segments;
• in the testicle - germination of the albumin;
• in the soft tissues of the extremities - the germination of fascia, limiting the anatomical segment: muscle, cell space.

At the second stage, when the tumor is removed, the excision area is expanded, so relapses are not frequent.

Sarcoma stage 3 is characterized by the germination of fascia and nearby organs. Sarcoma metastasizes to regional lymph nodes. The third stage appears:

• large size, severe pain syndrome, disruption of normal anatomical relationships and chewing in the mouth and tongue, metastases in the lymph nodes under the jaw and on the neck;
• large sizes, deforming the lip, spreading through the mucous membranes and metastases in the lymph nodes under the jaw and on the neck;
• violation of the functions of the organs located along the neck: the innervation and blood supply, swallowing and respiratory functions are upset with soft tissue sarcoma of the neck and cell spaces. With growth, the tumor reaches the vessels, nerves and nearby organs, metastases reach the lymph nodes of the neck and sternum;
• a sharp violation of breathing and distortion of the voice, germination in the organs, nerves, fascia and vessels in the neighborhood, metastasis from oncology of the larynx to the superficial and deep lymphatic cervical collectors;
• in the mammary gland - large sizes that deform the mammary gland and metastasize to the lymph nodes under the armpits or above the collarbone;
• in the esophagus - huge in size, reaching the tissue of the mediastinum and disrupting the food passage, metastases in the mediastinal LU;
• in the lungs - by squeezing the bronchi with large sizes, metastases in the LU of the mediastinum and peribronchial;
• in the testicle - deformation of the scrotum and germination of its layers, metastasis to the LU of the groin;
• in the soft tissues of the arms and legs - tumor foci 10 cm in size. As well as dysfunction of the limbs and deformation of tissues, metastases to regional lymph nodes.

At the third stage, extended surgical interventions are carried out, despite this, the frequency of recurrence of sarcoma increases, the results of treatment are ineffective.

Stage 4 sarcoma is very difficult, the prognosis after its treatment is the most unfavorable due to its gigantic size, sharp compression of the surrounding tissues and germination in them, the formation of a continuous tumor conglomerate, which tends to disintegrate and bleed. Often there is a recurrence of sarcoma of soft tissues and other organs after surgery or even complex treatment.

Metastasis reaches regional lymph nodes, liver, lungs, brain and bone marrow. It stimulates a secondary oncoprocess - the growth of a new sarcoma.

Metastases in sarcoma

Ways of metastasis of sarcoma can be lymphogenous, hematogenous and mixed. From the organs of the small pelvis, intestines, stomach and esophagus, larynx, metastases of sarcoma reach the lungs, liver, bones of the skeleton and other organs along the lymphogenous pathway.

Tumor cells or metastases also spread through the hematogenous pathway (through venous and arterial vessels) to healthy tissues. But sarcomas, for example, of the mammary and thyroid glands, pulmonary, bronchial, from the ovaries spread by lymphogenous and hematogenous routes.

It is impossible to predict the organ where the elements of the microvasculature will accumulate and the growth of a new tumor will begin. Dust metastases of the sarcoma of the stomach and pelvic organs spread through the peritoneum and chest area with hemorrhagic effusion - ascites.

Oncoprocess on the lower lip, the tip of the tongue and in the oral cavity metastasizes more to the lymph nodes of the chin and under the jaw. Formations in the root of the tongue, at the bottom of the oral cavity, in the pharynx, larynx, thyroid gland metastasize to the lymph nodes of the vessels and nerves of the neck.

From the mammary gland, oncocells spread to the region of the clavicle, to the LN from the outside of the sternocleidomastoid muscle. From the peritoneum, they enter the inner side of the sternocleidomastoid muscle and can be located behind or between its legs.

Most of all, metastasis occurs with Ewing's sarcoma in children and adults, lymphosarcoma, liposarcoma, fibrous histiocytoma, even with a size of up to 1 cm due to the accumulation of calcium in the tumor focus, intense blood flow and active growth of oncocells. These formations lack a capsule that could limit their growth and reproduction.

The course of the oncological process does not become more complicated, and its treatment due to metastases to regional lymph nodes will not be so global. With distant metastases in the internal organs, on the contrary, the tumor grows to large sizes, there may be several of them. Treatment becomes more complicated, complex therapy is used: surgery, chemistry and radiation. Remove, as a rule, single metastases. Excision of multiple metastases is not carried out, it will not be effective. Primary foci differ from metastases in a large number of vessels, cell mitoses. In metastases, there are more necrosing areas. Sometimes they are found earlier than the primary focus.

The consequences of sarcoma are as follows:

• surrounding organs are compressed;
• obstruction or perforation may occur in the intestine, peritonitis - inflammation of the abdominal sheets;
• elephantiasis occurs against the background of a disturbed outflow of lymph during compression of the lymph nodes;
• limbs are deformed, and movement is limited in the presence of large tumors in the area of ​​\u200b\u200bbones and muscles;
• internal hemorrhages occur during the disintegration of oncological formation.

Diagnosis of sarcomas

Diagnosis of sarcoma begins in the doctor's office, where it is determined by external diagnostic signs: emaciation, jaundice, pale skin color and discoloration over the tumor, cyanotic tint of the lips, swelling of the face, overflow of veins on the surface of the head, plaques and nodules in skin sarcoma.

Diagnosis of high-grade sarcoma is carried out according to the pronounced symptoms of intoxication of the body: loss of appetite, weakness, elevated body temperature and sweating at night. Cases of oncology in the family are taken into account.

When conducting laboratory tests, they examine:

• biopsy by histological method under a microscope. In the presence of tortuous thin-walled capillaries, multidirectional bundles of atypical cancer cells, altered large-nuclear cells with a thin membrane, a large amount of substance between the cells containing cartilage or hyaline connective tissue substances, histology diagnoses sarcoma. At the same time, in the nodes there are no normal cells characteristic of the tissue of the organ.
• anomalies in the chromosomes of cancer cells by the cytogenetic method.
• there are no specific blood tests for oncomarkers, so there is no way to unambiguously determine its variety.
• complete blood count: with sarcoma, it will show the following deviations:

1. hemoglobin and erythrocyte levels will decrease significantly (less than 100 g / l), which indicates anemia;
2. the level of leukocytes will slightly increase (above 9.0x109 / l);
3. the number of platelets will decrease (less than 150․109/l);
4. ESR will increase (above 15 mm/h).

• a biochemical blood test, it determines an elevated level of lactate dehydrogenase. If the enzyme concentration is above 250 U/l, then we can talk about the aggressiveness of the disease.

The diagnosis of sarcoma is supplemented by a chest x-ray. The method can detect a tumor and its metastases in the sternum and bones. Radiological signs of sarcoma are as follows:

• the tumor has a rounded or irregular shape;
• the sizes of education in a mediastinum happen from 2-3 mm to 10 and more cm;
• the structure of the sarcoma will be heterogeneous.

X-ray is necessary to detect pathology in the lymph nodes: one or more. In this case, the LU on the radiograph will be darkened. If a sarcoma is diagnosed on ultrasound, then it will be characteristic, for example:

• heterogeneous structure, uneven scalloped edges and lesions of the LU - with lymphosarcoma in the peritoneal region;
• the absence of a capsule, compression and expansion of surrounding tissues, foci of necrosis inside the tumor - with sarcoma in the organs and soft tissues of the abdominal cavity. Knots will be visible in the uterus and kidneys (inside) or in the muscles;
• formations of different sizes without borders and with foci of decay inside them - with skin sarcoma;
• multiple formations, heterogeneous structure and metastases of the primary tumor - with fatty sarcoma;
• heterogeneous structure and cysts inside, filled with mucus or blood, fuzzy edges, effusion in the cavity of the joint bag - with joint sarcoma.

Tumor markers in sarcoma are determined in each specific organ, as in cancer. For example, with ovarian cancer - CA125, CA 19-9, with breast sarcoma - CA15-3, gastrointestinal tract - CA19-9 or CEA, lungs - ProGRP (precursor of gastrin, releasing, peptide) and NSE, etc.

Computed tomography is performed with the introduction of an X-ray contrast agent to determine the location, boundaries of the tumor and its forms, damage to surrounding tissues, blood vessels, lymph nodes and their fusion into conglomerates.

Magnetic resonance imaging is carried out to identify the exact size, metastases, destruction of the skin, bones, tissues, periosteal fibrillation, thickening of the joints, and more.

The diagnosis is confirmed by a biopsy and determines the malignancy by histological examination:

• bundles of tangled spindle-shaped cells;
• hemorrhagic exudate - fluid coming out of the walls of blood vessels;
• hemosiderin - a pigment formed during the breakdown of hemoglobin;
• giant atypical cells;
• mucus and blood in the sample and otherwise.

Lumbar (spinal) puncture tests will indicate sarcoma, where there may be traces of blood and many atypical cells of different sizes and shapes.

Treatment

Treatment of sarcoma is carried out using a comprehensive differentiated approach:

1. removal of sarcoma by surgical methods;
2. chemotherapy: drugs are administered for sarcoma: Ifosfamide, Dacarbazine, Doxorubicin, Vincristine, Cyclophosphamide, Methotrexate;
3. remote radiation and radioisotope therapy.

Specific methods are determined depending on the location, type, stage, general condition, age and previous therapy of the patient.

Surgery for aggressive sarcoma is performed in the early stages to remove all malignant cells and exclude metastases. Together with the tumor, 1-2 cm of healthy tissue is removed without touching the nerves and blood vessels, while maintaining the functions of the organ. Do not remove:

• after 75 years;
• with severe diseases of the heart, kidneys and liver;
• with a large tumor in vital organs that cannot be removed.

The following therapeutic tactics are also used:

1. With low- and moderately differentiated sarcomas at stages 1-2, operations and regional lymph node dissection are performed. After - polychemotherapy (1-2 courses) or external beam radiation therapy for sarcoma.
2. With highly differentiated sarcomas at stages 1-2, surgical treatment and extended lymph node dissection are performed. Chemotherapy is performed before and after surgery, and radiation therapy is added in complex treatment.
3. At the third stage of the oncological process, combined treatment is carried out: before surgery, radiation and chemotherapy are used to reduce the size of the tumor. During the operation, all germinating tissues, collectors of regional lymphatic drainage are removed. Restore important damaged structures: nerves and blood vessels.
4. Amputation is often required for sarcomas, especially osteosarcomas. Bone resection is performed for low-grade superficial osteosarcomas in older people. Next is prosthetics.
5. At the 4th stage, symptomatic treatment is used: anemia correction, detoxification and analgesic therapy. For complex full-fledged treatment at the last stage, access to oncological formation is necessary for the purpose of its removal, small size, location in the surface layers of tissues, single metastases.

Of the modern methods, remote radiation therapy with linear accelerators is used according to special programs that plan the irradiation fields and calculate the power and doses of exposure to the oncoprocess zone. Radiotherapy is carried out under full computerized control and automatic verification of the correctness of the settings set on the accelerator control panel in order to eliminate human error. Brachytherapy is used for sarcomas of different localization. It accurately irradiates the tumor with a high dose of radiation without damaging healthy tissue. The source is introduced into it by remote control. Brachytherapy can replace surgery and external radiation in some cases.

Traditional medicine for sarcoma

Treatment of sarcoma with folk remedies is included in complex therapy. For each type of sarcoma there is its own medicinal herb, mushrooms, resins, food. Diet in oncology is of great importance, since fortified foods and with the presence of micro- and macroelements increase immunity, give strength to fight cancer cells, and prevent metastasis.

For malignant sarcomas, treatment is carried out:

• henbane black;
• hemlock spotted;
• bullock;
• cocklebur;
• water lily white;
• grape clematis;
• poppy samosey;
• sun milk,
• red fly agaric;
• norichnik knotty;
• mistletoe white;
• incense pikulnik;
• peony evasive;
• European wormwood;
• common hop;
• common blackhead;
• large celandine;
• saffron seed;
• ash is tall.

With chronic sarcoma ulcers on the skin and mucous membranes, they treat avran officinalis, skin sarcoma - wolfberry, medicinal sweet clover, cocklebur, kirkazon and grape-leaved clematis, euphorbia-sun-gazer and bittersweet nightshade, common tansy and European dodder, common hops and medicinal garlic.

During the oncological process in the organs, drugs will be needed:

• in the stomach - from wolfberry, crow, common dope and cocklebur, evading peony, large celandine and bitter wormwood;
• in the duodenum - from aconites, marsh belozor;
• in the esophagus - from spotted hemlock;
• in the spleen - from wormwood;
• in the prostate gland - from spotted hemlock;
• in the mammary gland - from spotted hemlock, icterus levkoin and common hops;
• in the uterus - from evading peony, bitter wormwood, hellebore Lobel and sowing saffron;
• in the lungs - from the magnificent colchicum and cocklebur.

Osteogenic sarcoma is treated with tincture: crushed St. John's wort (50 g) is poured with grape vodka (0.5 l) and infused for two weeks with daily shaking of the container. Before meals, take 30 drops 3-4 times.

With sarcoma, folk remedies are used according to the method of M.A. Ilves (from the book "The Red Book of the White Land"):

1. To increase immunity: mixed in equal weight fractions: tartar (flowers or leaves), calendula flowers, tricolor and field violets, cocklebur, chamomile flowers and veronica, celandine and sandy immortelle flowers, mistletoe and young burdock root. Brew 2 tbsp. l. collection of 0.5-1 l of boiling water and insist 1 hour. Drink during the day.
2. Divide the herbs from the list into 2 groups (5 and 6 items each) and drink for 8 days each collection.

Important! In the collection, plants such as celandine, violet, cocklebur and mistletoe are poisonous. Therefore, the dose cannot be exceeded.

To eliminate cancer cells, the treatment of sarcoma with folk remedies includes the following Ilves recipes:

• grind celandine in a meat grinder and squeeze out the juice, mix with vodka in equal parts (preserve) and store at room temperature. Drink 3 times a day for 1 tsp. with water (1 glass);
• crush 100 g of root marin (evading peony) and pour vodka (1 l) or alcohol (75%), leave for 3 weeks. Take 0.5-1 tsp. 3 times with water;
• grind white mistletoe, place in a jar (1 l) by 1/3, pour vodka to the top and let it brew for 30 days. Separate the thick and squeeze, drink 1 tsp. 3 times with water;
• grind the root of the meadowsweet - 100 g and pour vodka - 1 liter. Insist 3 weeks. Drink 2-4 tsp. 3 times a day with water.

The first three tinctures should be alternated after 1-2 weeks. The tincture of the meadowsweet is used as a spare. All tinctures are taken for the last time before evening dinner. The course - 3 months, in the interval between the monthly course (2 weeks) - drink the meadowsweet. At the end of the 3-month course, drink meadowsweet or one of the tinctures once a day for another 30 days.

Nutrition for sarcoma

The diet for sarcoma should consist of the following products: vegetables, herbs, fruits, fermented milk, rich in bifidus and lacto bacteria, boiled (steam, stew) meat, cereals as a source of complex carbohydrates, nuts, seeds, dried fruits, bran and germinated cereals , wholemeal bread, cold-pressed vegetable oils.

To block metastases in the diet include:

• fatty sea fish: saury, mackerel, herring, sardine, salmon, trout, cod;
• green and yellow vegetables: zucchini, cabbage, asparagus, green peas, carrots and pumpkin;
• garlic.

You should not eat confectionery products, as they are stimulators of oncocell division, as sources of glucose. Also products with the presence of tannin: persimmon, coffee, tea, bird cherry. Tannin, as a hemostatic agent, promotes thrombosis. Smoked meats are excluded as sources of carcinogens. You can not drink alcohol, beer, the yeast of which feeds cancer cells with simple carbohydrates. Sour berries are excluded: lemons, lingonberries and cranberries, since cancer cells actively develop in an acidic environment.

Life prognosis for sarcoma

A five-year survival rate for soft tissue and limb sarcoma can reach 75%, up to 60% for oncological processes on the body.

In fact, even the most experienced doctor does not know how long they live with sarcoma. According to studies, life expectancy with sarcoma is affected by forms and types, stages of the oncological process, and the general condition of the patient. With adequate treatment, a positive prognosis is possible in the most hopeless cases.

Disease prevention

Primary prevention of sarcoma includes active identification of patients at increased risk of developing the disease, including those infected with herpes virus VIII (HHV-8). Patients receiving immunosuppressive therapy should be especially closely monitored. In prevention, conditions and diseases that cause sarcoma should be eliminated and treated.

Secondary prevention is carried out in patients in remission to prevent recurrence of sarcoma and complications after a course of treatment. As a preventive measure, you should drink brewed herbs instead of tea according to the Ilves method (p. 1) for 3 months, take a break for 5-10 days and repeat the intake. Sugar or honey can be added to tea.

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