In the adult population, soft tissue sarcomas of the abdomen and pelvis are usually larger in size at diagnosis, as they are usually clinically silent or produce vague or mild symptoms until they invade or contract vital organs. Imaging features of abdominal and pelvic sarcoma and abdominal wall sarcomas may be indefinite and overlap with more common pathological conditions, making the diagnosis difficult or in some cases delayed.
What is intra-abdominal sarcoma?
Tissue expressed as intra-abdominal sarcoma, i.e., soft tissue, acts as a structure and support around various organs and tissues of the body; Adipose tissue, muscle group, tissue that makes blood vessels and connective tissue. A wide variety of cancers arising from these tissues are known as soft tissue cancers. Soft tissue cancer can occur from any part of the body; Depending on the type of cell from which the tumor tissue develops, it may show different biological and clinical features.
The most common clinical types of soft tissue cancer can be summarized as follows:
Liposarcoma: Liposarcoma develops as a result of cancer of the adipose tissue cells of the body. It can occur in any area of the body where adipose tissue is located. It is the most common subtype of all soft tissue tumors.
Leiomyosarcoma: These are tumors that originate from a group of cells called smooth muscle located in the tissues that make up internal organs such as the digestive system, excretory system or reproductive system.
Rhabdomyosarcoma: Rhabdomyosarcoma develops when the skeletal muscle responsible for body movements becomes cancerous and the proliferation is uncontrolled. It is the most common soft tissue tumor in children and adolescents.
Liposarcoma (well-differentiated and differentiated liposarcomas), leiomyosarcoma, and gastrointestinal stromal tumors (GIST) are the most common primary intra-abdominal primary sarcomas.
What is the reason?
Like other types of cancer, the underlying cause of soft tissue cancer is not well known. However, scientific studies have shown that some factors increase the risk of soft tissue cancer.
What are the risk factors for soft tissue cancer?
Genetic predisposition: A significant proportion of soft tissue cancers are found in families, especially in individuals with a history of similar cancers in their first-degree relatives. It has been determined that people with genetic mutation syndrome have a higher risk of developing soft tissue cancer, which can lead to cancer cell formation. Some of these syndromes can be listed as Gardner syndrome, tuberous sclerosis, neurofibromatosis, Li-Fromeni syndrome.
Chemical: People who come in contact with the chemical have an increased risk of developing soft tissue cancer.
Infection: Viral infections, such as HHV-8, can lead to soft tissue cancer.
Radiation: In the long run, the risk of developing soft tissue cancer in different parts of the body is increased due to the application of radiotherapy so that high levels of radiation are given.
What are the symptoms?
Clinical symptoms caused by soft tissue cancer; It depends on various conditions such as the location of the tumor, its size, its biological characteristics, its relation to the surrounding tissue, the presence of metastasis. However, symptoms such as limited swelling or hardening of the tumor, pain due to mass pressure on the surrounding tissue, restriction of movement depending on the size and location of the mass, narrowing or obstruction of the bowel, and shortness of breath may be observed.
How is it diagnosed?
A patient with suspected soft tissue cancer is first evaluated in detail by physical examination and radiological imaging, then a biopsy is planned for the detected mass.
Ultrasound: Ultrasound is a preferred method of initial assessment of mass size, its physical characteristics, and its relationship to the surrounding tissue. It is especially preferred by the easily accessible, surface masses.
Computed tomography (CT): CT can be used to assess the size, physical characteristics, and mass spread of deep tissue, especially those located in the abdomen or chest.
Magnetic Resonance (MR): Since soft tissue tumors may exhibit features similar to those of healthy tissues, detailed evaluation of tissues may be required. MRI; It can be preferred in evaluation as it offers more detailed imaging than City.
PET-CT: In the PET-CT method, which allows the whole body to be scanned for cancerous populations, a special substance is injected intravenously, enabling the scarring of cancer cells. Thus, important information for treatment planning is obtained by staging cancer.
How is it treated?
In soft tissue cancer, treatment depends on the stage of the disease; The size of the mass, its spread, whether it metastasizes, whether it invades the surrounding tissue, varies depending on the subject. Since soft tissue cancer is a common name given to multiple cancer subtypes that may show different clinical features, the type diagnosed after pathological examination may also influence the treatment decision.
Robotic Surgery: Surgical removal of the tumor is the first step in the initial treatment of a population that has been detected at an early stage, has not metastasized, and has not spread to surrounding tissues. The minimum incision and maximum success rate can be achieved through laparoscopic and robotic surgery techniques.
Heat chemotherapy: Hot chemotherapy, a combination of different drugs, can be applied before, after surgery, or independently according to the pathological features of the tumor.
Radiotherapy: After surgery or with chemotherapy, radiotherapy may be applied at a dose and time prescribed by the patient to quickly remove the tumor mass or to remove cancer cells that cannot be surgically removed.