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Sarcomas

Definition

Sarcomas are cancerous tumors of bone or soft tissue. They are classified primarily by the tissue from which they arise. The most common sarcomas in childhood are:

• rhabdomyosarcoma (rab-doe-MY-oh-sar-KOH-mah)
  
• Ewings (yoo-wings) sarcoma
  
• osteosarcoma (OSS-tee-oh-sarcoma).

Getting Diagnosed / Treatment

Sarcomas that effect children are treated at the U-M Cancer Center in the Pediatric Connective Tissue Oncology Clinic.

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The proper diagnosis, treatment and the chance for cure depends on the proper surgical and medical management of these tumors. It is very important that children with suspected sarcoma be cared for at a hospital where specialists in children's cancer are located, such as the U-M. Rhabdomyosarcoma arises in a variety of sites. Almost 40 percent arise in the head and neck. The next most common sites include the vagina, bladder, uterus, prostate, testes, extremities and trunk. Children of all ages, from newborns to teens, may develop rhabdomyosarcoma.

What are the symptoms of sarcomas?

Symptoms depend on where the sarcoma is located. If sarcoma is suspected, it is important that a complete evaluation of sites of disease occur to establish if the sarcoma has spread.

How are sarcomas treated?

The likelihood of cure is related to the site and extent of disease. Some tumors are best managed by initial biopsy, when the sample of tissue is removed to be examined, followed by chemotherapy and irradiation. Others have a higher chance for cure if as much tumor as possible is removed at diagnosis by the surgeon.

Osteosarcoma is the most common malignant tumor of bone. It is most often diagnosed in growing teenagers. Most often these teenagers have symptoms of a swelling in an arm or leg that may or may not be painful. When this form of cancer spreads, it is most often to the lungs or other bones.

Appropriate surgical management is very important in osteosarcoma. The orthopedist must biopsy, or remove, the mass so as to not cause spread of the cancer cells. If this is done properly and the cancer responds well to chemotherapy, amputation is usually not necessary. Limb saving surgery can be performed by orthopedic surgeons experienced in caring for children with bone tumors.

Ewings sarcoma is the second most common malignant bone tumor of children and young adults. Children present with pain and swelling of the affected bone or region, most commonly the hip bones, upper arms and legs. However, any bone may be affected.

The proper planning of the biopsy procedure is extremely important and should only be performed by orthopedists experienced in the care of children with malignant bone tumors. If Ewing's sarcoma is not treated with chemotherapy, more than 90 percent of patients will develop widespread disease most often in the lungs, other bones and bone marrow. A combined approach with surgery, radiation therapy and chemotherapy has improved the chance for cure for these children.

How can I get more information about sarcoma?

Telephone our Cancer AnswerLine at 800-865-1125 or e-mail a nurse.

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