Sarcoma is treatable. Relapses of tumors and tumor-like lesions of bones and soft tissues. When carrying out laboratory tests, they examine

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Treatment of tumors and tumor-like lesions of the osteoarticular system depends on the nature, location and extent of the process.

The method of choice is surgical removal of the pathological formation.

Of the benign tumors, giant cell tumor (osteoclastoma) and cartilaginous tumors recur most often, mainly after non-radical surgical removal or malignant degeneration.

Of the malignant tumors, chondrosarcomas, malignant chordomas and osteoclastomas, and soft tissue sarcomas that are insensitive or insensitive to ionizing radiation are subject to surgical treatment. For osteogenic sarcoma, Ewing's sarcoma, malignant lymphomas (reticulosarcoma, lymphosarcoma), and vascular tumors, combined treatment is used using surgery, radiation therapy, chemotherapy and hormonal therapy.

Recurrences of benign tumors and tumor-like bone lesions

Recurrences of aneurysmal bone cyst, solitary bone cyst, osteoid osteoma, desmoplastic fibroma, fibrous dysplasia occur only within the operated bone, without damage to the surrounding soft tissues. Repeated relapses are much less common (with osteoclastoma or malignant cartilaginous tumor) and are usually localized in soft tissues. However, repeated relapses can also be observed in the operated bone after non-radical removal of the tumor tissue of the first relapse. Fibrous dysplasia recurs many times within the affected area of ​​the bone.

The clinical manifestations of a recurrent tumor are less pronounced than those of the primary tumor, and may be absent for a long time after surgery. Relapse of chondroblastoma has its own characteristics. For the first few months it is asymptomatic, and then a pain symptom appears, which gradually intensifies over time and becomes painful for the patient. Low-grade fever also appears. In the area of ​​the scar, palpation is painful, the surrounding skin is hyperemic, swollen, with a local increase in temperature. Only radical surgery relieves the patient of pain.

Radiographically, in the early stages after surgery, relapses of benign tumors are manifested by destruction along the edges of the bone sawdust. Subsequently, multiple small foci of destruction with unclear contours appear. In such observations, the use of traditional tomography and computed tomography is effective, and in cases after osteoplastic operations with resection of the articular end, radiography with direct image magnification is used.

During dynamic X-ray observation, a fusion of small and medium-sized foci is noted with the formation of large areas of destruction, which, as a rule, occupy the entire diameter of the bone. At the same time, thinning and destruction of the cortical layer is noted. In the latter case, the tumor grows into the paraosteal soft tissue. Swelling is also observed. The severity of swelling depends on the duration of the relapse process. At first, the foci of destruction are homogeneous, and then a heterogeneous cellular structure appears. It should be especially emphasized that destruction during tumor recurrence tends to spread to the graft.

It was said above that the recurrence of some benign bone tumors (osteoclastoma - giant cell tumor, osteoblastoma, chondroblastoma, chondromyxoid fibroma, ec- and enchodroma) can be localized in soft tissues. In such cases, additional formations of a round shape, varying in size, intensity and structure, begin to be identified in the soft tissues radiographically. They can be located in the muscle mass, isolated in the subcutaneous fatty tissue, or simultaneously in them. The structure of a recurrent tumor is usually homogeneous.

There are no pathognomonic radiological signs of malignancy of a benign bone tumor during its recurrence.

Malignant degeneration is characterized by the same radiological signs as the recurrence of a benign tumor. First, small foci of destruction appear, and then thinning of the cortical layer, its destruction and tumor growth into soft tissue with the formation of an extraosseous component. The graft is usually destroyed. However, the progression of the process occurs more quickly than with relapse of a benign tumor.

It is noteworthy that radiological manifestations of recurrence of a benign tumor and tumor-like lesions noticeably (from several months to several years) precede the appearance of clinical symptoms. Therefore, for their timely detection, regular control X-ray examination of patients is necessary.

It is recommended to carry out a control X-ray examination of such patients according to the following scheme: during the first year after surgery, X-rays should be taken every three months; during the second year - every six months and during the third and subsequent years - once a year. The control radiological examination should include, in addition to traditional radiography, computed tomography. If osteoclastoma recurs, angiography should be used to clarify the soft tissue component.

It should be remembered that intense and uneven contrasting of the tumor occurs quickly and intensifies towards the beginning of the venous phase. Venous outflow also increases. Pathological vessels are identified along the periphery of the tumor. With malignant degeneration of osteoclastoma, the presence of many pathological vessels throughout the tumor in combination with early enhanced contrast and early venous outflow is determined angiographically.

When analyzing radiographs and angiograms, one should remember about the radiological manifestations of postoperative complications (secondary osteomyelitis, osteolysis of the graft, pathological restructuring of the graft), as well as the various phases of the recovery process.

In the diagnosis of tumor recurrence, it is possible to use radionuclide testing.

In cases where clinical, x-ray and radiological examination does not resolve the diagnostic problem, a repeat examination after 2-3 weeks or a biopsy is recommended.

Recurrence of malignant bone tumors

Repeated relapses are characteristic of malignant chordoma and chondrosarcoma. The latter usually recur in the first six months after surgery. With other malignant tumors, relapses occur within a period of 3 months to 3 years. Osteogenic sarcoma and malignant osteoclastoma usually recur in the first month after surgery.

Clinically, tumor relapse is manifested by a painful symptom that progresses rapidly. It especially increases when a tumor appears in the area of ​​the postoperative scar. The general body temperature rises, and blood tests show a moderate increase erythrocyte sedimentation rate (ESR). In advanced cases, the skin over the tumor becomes ulcerated and begins to bleed.

Radiologically, relapse is characterized by progressive destruction of bone and graft, as well as soft tissue infiltration. In this case, various periostoses appear (linear, visor, radiant, multilayer). Recurrence of chondrosarcoma is accompanied by the formation of structureless calcifications in the bone or soft tissues.

In cases where the nature of the primary tumor is known, diagnosing relapse is not difficult. If the form of the primary tumor is unknown, then traditional radiography only confirms the fact of relapse, because X-ray semiotics of relapses of malignant tumors is not specific for various nosological forms.

Angiography also allows you to confirm the malignant nature of the relapse, because makes it possible to determine the extent of tumor spread into soft tissues, the nature of vascularization and the involvement of great vessels in the process. With relapses of osteogenic sarcoma, chondrosarcoma, reticular sarcoma, lymphosarcoma and malignant osteoclastoma, pronounced vascular atypia is observed. Radionuclide testing allows for differential diagnosis of an established hematoma and a recurrent tumor.

Recurrence of soft tissue tumors

Clinically, such relapses are manifested by the appearance of a compaction in or near the postoperative scar and a pain symptom. When relapses of pelvic soft tissue tumors occur, the first symptoms are radiating pain, constipation or dysuria.

X-ray diagnosis of relapse is based on traditional radiography, pneumography, angiography, and computed tomography. On plain radiographs of the affected area, in most cases, a relapse can be recognized by the presence of areas of darkening of an indefinite or round shape, with an intensity equal to or higher than the intensity of the muscle mass.

The structure of the darkening focus is homogeneous; calcareous inclusions are less common. Secondary changes in the adjacent bone are also possible (pressure atrophy, marginal destruction, periostosis or hyperostosis). In cases where traditional radiographs cannot detect signs of recurrent soft tissue tumors, pneumography, angiography or computed tomography should be used.

The angioarchitecture of a recurrent benign soft tissue tumor does not differ from that in normal tissue. However, displacement of the great vessels may be observed. The angiographic picture of a recurrent malignant tumor of soft tissues is characterized by atypical vessels, enhanced by continued contrast, “amputation” of feeding arteries, lacunae, early venous outflow and blurred contours of the great vessels.

The nature of the blood supply to recurrent tumors does not differ from the architecture of the primary tumor of the same structure. But unlike primary tumors, during relapses there is a more frequent involvement of the great vessels in the process. When using the radionuclide method, it should be remembered that recurrent benign soft tumors do not tend to have a high level of accumulation radiopharmaceutical (radiopharmaceuticals). The exceptions are fibromas and neurofibromas.

In case of relapses of malignant soft tissue tumors, the level of radiopharmaceutical accumulation is quite high, which makes it possible to recommend this method in practice. Control examination of patients to diagnose recurrent soft tissue tumors should be carried out as often as after removal of bone tumors, especially during the first year after surgery.

Kochergina N.V.

The development of low-grade stromal endometrial sarcoma is the formation of a neoplasm in the tissues of the uterus in women. The disease occurs in patients aged 50 years, and sometimes affects young girls.

Causes

Why endometrial stromal sarcoma develops in the uterine region is unknown. This issue is still being researched and discussed by scientists. Experts identify several reasons for which a woman is considered at risk:

1. Bad habits.
2. Damage to the uterus due to abortion, surgery, wearing an intrauterine device.
3. Hormonal imbalance in the body.
4. Impact of harmful substances on the body.
5. The presence of benign formations of the genital organs.
6. Inflammatory processes in the reproductive system that occur over a long period of time.

The list of provoking factors does not end there. As scientists study bladder pathology, they include new predisposing phenomena.

Signs

Endometrial stromal sarcoma can be a single nodule or multiple lesions. Often the tumor protrudes into the uterine cavity. The pathological process also affects blood and lymphatic vessels.

Symptoms of low-grade endometrial stromal sarcoma are in many ways similar to other diseases of the reproductive system. Frequent complaints from patients include:

• Heavy uterine bleeding.
• Pain syndrome in the lower abdomen.
• Increased volume of the uterus.
• Problems with urination and bowel movements due to pressure on the pelvic organs from an overgrown tumor.

In case of damage to neighboring organs, additional signs appear.

Diagnostics

Endometrial stromal sarcoma is detected using various examination methods. First of all, a gynecological examination is performed. Already during the process, the doctor notices changes in the tissues of the uterus and can detect a formation, if its size allows it.

After being examined by a gynecologist, the woman is sent for blood and urine tests and an ultrasound examination of the pelvic organs. A biopsy of the affected tissues and their study during histology is required.

Pathology therapy

Surgery is the most effective treatment for endometrial stromal sarcoma. The extent of the operation depends on the degree of damage to the uterus. If the tumor is small, organ-preserving removal is performed. During the process, only the lesion is excised, without removing the entire organ.

If the formation is large, then they resort to amputation of the uterus. Often removal is carried out along with the appendages. As a supplement, chemical therapy or radiation exposure is used.

Prognosis and prevention

The prognosis for low-grade endometrial stromal sarcoma is favorable in most cases, since the disease develops slowly and is characterized by late metastasis. Only in advanced cases is a woman’s life at risk.

To prevent the development of uterine disease, you should pay attention to the following recommendations from gynecologists and oncologists:

1. Do not ignore inflammatory processes and benign formations in the reproductive system.
2. Don't allow abortions.
3. Do not wear an intrauterine device for more than the prescribed period.
4. Lead a healthy lifestyle.
5. Avoid exposure to carcinogens and other harmful substances.
6. Regularly undergo examination by a gynecologist.

Despite the favorable course of endometrial sarcoma with a low degree of malignancy, it is better to prevent its development.

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

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

Is sarcoma cancer or not?

Some signs 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 in organ tissues.

How does cancer differ from sarcoma?

• The cancer tumor has the appearance of a lumpy conglomerate that grows rapidly without symptoms in the first stages. Sarcoma is pinkish in color, reminiscent of fish flesh;
• a cancer tumor affects epithelial tissue, sarcoma affects muscle connective tissue;
• Cancer development occurs gradually in any specific organ in people after 40 years of age. Sarcoma is a disease of young people and children; it instantly affects their bodies, but is not tied to any one organ;
• Cancer is easier to diagnose, which increases cure rates. Sarcoma is more often detected at stages 3-4, so its mortality rate is 50% higher.

Is sarcoma contagious?

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

Sarcoma in HIV is a multiple hemorrhagic sarcomatosis called "angiosarcoma" or "". It is recognized by ulcerations of the skin and mucous membranes. A person becomes ill as a result of herpes infection type 8 through the lymph, blood, secretions of the patient’s skin and saliva, as well as through sexual contact. Even with antiviral therapy, Kaposi's tumor often recurs.

The development of sarcoma against the background of HIV is possible with a sharp decrease in immunity. In this case, patients may be diagnosed with AIDS or a disease such as lymphosarcoma, leukemia, lymphogranulomatosis or myeloma.

Causes of sarcomas

Despite the variety of types, sarcoma is rare, accounting for only 1% of all cancers. The causes of sarcoma are varied. Among the established causes are: exposure to ultraviolet (ionizing) radiation, radiation. Viruses and chemicals, precursors of the disease, and benign neoplasms that turn into oncological ones also become risk factors.

The causes of Ewing's sarcoma may be the rate of bone growth and hormonal levels. Risk factors such as smoking, working in chemical plants, and contact with chemicals are also important.

Most often, this type of oncology is diagnosed due to the following risk factors:

• hereditary predisposition and genetic syndromes: Werner, Gardner, multiple pigmented skin cancer of basal cells, neurofibromatosis or retinoblastoma;
• herpes virus;
• lymphostasis of the legs in a chronic form, the recurrence of which occurred after radial mastectomy;
• injuries, wounds with suppuration, exposure to cutting and piercing objects (shards of glass, metal, wood chips, etc.);
• immunosuppressive and polychemotherapy (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 vital organs. The nature of the symptoms is influenced by the biological characteristics of the root cause of the cell and the tumor itself. Early signs of sarcoma are the noticeable size of the formation, as it grows rapidly. Pain in joints and bones appears early (especially at night), which is not relieved by analgesics.

For example, due to the growth of rhabdominosarcoma, the oncological process spreads to the tissues of healthy organs and is manifested by 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 swellings in the lymph node. But even with sizes of 2-30 cm, a person may not feel pain at all.

With other types of tumors with rapid growth and progression, the following may appear: fever, veins under the skin, and cyanotic ulcerations on them. Palpation of the formation reveals that it has limited mobility. The first signs of sarcoma are sometimes characterized by deformation of the joints of the limbs.

Liposarcoma, 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 the primary tumor that produces metastases.

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 nearby tissues.

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 side of the heart may enlarge.

Cells of the nerve sheaths degenerate into neurofibrosarcoma, cells and connective tissue fibers into. 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 their location.

AND Of the 100 types, 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 ones are especially often diagnosed in fatty and soft tissues:

• , developing from adipose tissue;
• , which refers to fibroblastic/myofibroblastic formations;
• fibrohistiocytic tumors of soft tissues: plexiform and giant cell;
• – from smooth muscle tissue;
• glomus tumor (pericytic or perivascular);
• from the muscles of the skeleton;
• and epithelioid hemangioepithelioma, which refers to vascular formations of soft tissue;
• mesenchymal chondrosarcoma, extraskeletal osteosarcoma – osteochondral tumors;
• malignant gastrointestinal tract tumor (stromal tumor of the gastrointestinal tract);
• tumors of the nerve trunk: peripheral nerve trunk, triton tumor, granulocelloma, 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.

According to the WHO classification (ICD-10), the following tumors are often found among bone tumors:

• cartilage tissue - chondrosarcoma: central, primary or secondary, peripheral (periosteal), clear cell, dedifferentiated and mesenchymal;
• bone tissue - osteosarcoma, a common tumor: chondroblastic, fibroblastic, osteoblastic, as well as telangiectatic, small cell, central low-grade, secondary and paraosteal, periosteal and superficial high-grade;
• fibrous tumors – fibrosarcoma;
• fibrohistiocytic formations - malignant fibrous histiocytoma;
• / PNET;
• hematopoietic tissue - plasmacytoma (myeloma), malignant lymphoma;
• giant cell: malignant giant cell;
• tumor formation of the notochord - “Dedifferentiated” (sarcomatoid);
• vascular tumors – angiosarcoma;
• smooth muscle tumors – leiomyosarcoma;
• tumors from adipose tissue - liposarcoma.

The maturity of all types of sarcomas can be low-, medium- and highly differentiated. The lower the differentiation, the more aggressive the sarcoma. Treatment and survival prognosis depend on the maturity and stage of formation.

Stages and degrees of 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 occurs slowly. It is dominated by stroma - normal connective tissue with a small percentage of oncoelements. The tumor 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 sarcoma forms a dense vascular network with a large number of high-grade cancer cells, and metastases spread early. Surgical treatment of high-grade lesions may be ineffective.
3. Moderately differentiated degree, in which the tumor has intermediate development, and with adequate treatment a positive prognosis is possible.

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

The initial stage of sarcoma is characterized by small size. It does not spread beyond the organs or segments where it originally appeared. There are no disturbances in the working functions of organs, compression, or metastasis. There is virtually no pain. If a well-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 the following:

• in the oral cavity and on the tongue - a small node up to 1 cm in size appears in the submucosal layer or mucous membrane and has clear boundaries;
• on the lips - the node is felt in the submucosal layer or inside the lip tissue;
• in the cellular spaces and soft tissues of the neck - the size of the node reaches 2 cm, it is located in the fascia that limits its location and does not extend beyond its limits;
• in the area of ​​the larynx - the mucous membrane or other layers of the larynx limit the node, up to 1 cm in size. It is located in the fascial sheath, does not extend beyond it and does not interfere with phonation and breathing;
• in the thyroid gland - a node, up to 1 cm in size, located inside its tissues, capsule germination does not occur;
• in the mammary gland - a node up to 2-3 cm grows in the lobule and does not extend beyond its limits;
• in the area of ​​the esophagus - an oncological node up to 1-2 cm is located in its wall, without disturbing the passage of food;
• in the lung - manifested by damage to one of the segments of the bronchi, without going beyond its limits and without disrupting the working function of the lung;
• in the testicle - a small node develops without involving the tunica albuginea;
• in the soft tissues of the extremities - the tumor reaches 5 cm, but is located within the fascial sheaths.

Stage 2 sarcoma is located inside the organ, grows into all layers, disrupts the functional functioning of the organ as it increases in size, but there is no metastasis.

The oncological process manifests itself like this:

• in the oral cavity and on the tongue - noticeable growth in the thickness of the tissues, germination of all membranes, mucosa and fascia;
• on the lips - by germination of the skin and mucous membranes;
• in the cellular spaces and soft tissues of the neck - up to 3-5 cm in height, extending beyond the fascia;
• in the area of ​​the larynx – the growth of the node is more than 1 cm, the germination of all layers, which disrupts phonation and breathing;
• 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 – node growth up to 5 cm and germination of several segments;
• in the esophagus - by germination of the entire thickness of the wall, including the mucous and serous layers, 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 - by germination of the tunica albuginea;
• in the soft tissues of the extremities - by the germination of fascia limiting the anatomical segment: muscle, cellular space.

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

Stage 3 sarcoma is characterized by invasion of the fascia and nearby organs. Metastasis of the sarcoma to regional lymph nodes occurs.

The third stage appears:

• large sizes, severe pain, disruption of normal anatomical relationships and chewing in the oral cavity and tongue, metastases in the lymph nodes under the jaw and on the neck;
• large in size, deforming the lip, spreading through the mucous membranes and metastases to the lymph nodes under the jaw and on the neck;
• dysfunction of organs located along the neck: innervation and blood supply, swallowing and respiratory functions are disrupted in soft tissue sarcoma of the neck and cellular spaces. As the tumor grows, it reaches blood vessels, nerves and nearby organs; metastases reach the lymph nodes of the neck and sternum;
• sudden respiratory failure and distortion of the voice, germination into organs, nerves, fascia and vessels in the neighborhood, metastasis from laryngeal cancer to the superficial and deep lymphatic cervical collectors;
• in the mammary gland - large in size, which deforms the mammary gland and metastasizes to the lymph nodes under the armpits or above the collarbone;
• in the esophagus - huge in size, reaching the mediastinal tissue and disrupting the food passage, metastases in the mediastinal lymph nodes;
• in the lungs – compression of the bronchi with large sizes, metastases in the mediastinal and peribronchial lymph nodes;
• in the testicle – deformation of the scrotum and germination of its layers, metastasis to the groin lymph nodes;
• in the soft tissues of the arms and legs - tumor foci measuring 10 centimeters. As well as dysfunction of the limbs and tissue deformation, metastases to regional lymph nodes.

At the third stage, extended surgical interventions are performed, despite this, the frequency of sarcoma relapses increases, and treatment results 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 surrounding tissues and germination into them, the formation of a continuous tumor conglomerate, which is prone to bleeding. Often there is a relapse of sarcoma of soft tissues and other organs after surgery or even complex treatment.

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

Metastases in sarcoma

The routes of metastasis of sarcoma can be lymphogenous, hematogenous and mixed. From the pelvic organs, intestines, stomach and esophagus, larynx, sarcoma metastases reach the lungs, liver, skeletal bones and other organs through the lymphatic pathway.

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

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

The oncological process on the lower lip, 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, and thyroid gland metastasize to the lymph nodes of the vessels and nerves of the neck.

From the mammary gland, cancer cells spread to the clavicle area, to the lymph nodes on the outside of the sternocleidomastoid muscle. From the peritoneum they reach the inner side of the sternocleidomastoid muscle and can be located behind or between its legs.

Most metastasis occurs in 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 cancer cells. 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 in connection with metastases to regional lymph nodes will not be so global. With distant metastases in the internal organs, on the contrary, the tumor grows to a large size, there may be several of them. Treatment becomes more complicated; complex therapy is used: surgery, chemotherapy and radiation. As a rule, single metastases are removed. Excision of multiple metastases is not performed; it will not be effective. Primary foci differ from metastases in a large number of vessels and cell mitoses. Metastases have more necrotic 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 layers;
• elephantiasis occurs due to impaired lymph outflow due to compression of the lymph nodes;
• limbs are deformed and movement is limited in the presence of large tumors in the area of ​​bones and muscles;
• Internal hemorrhages occur during the disintegration of tumor formation.

Diagnosis of sarcomas

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

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

When carrying out laboratory tests, the following is examined:

• biopsy by histological method under a microscope. In the presence of tortuous thin-walled capillaries, multidirectional bundles of atypical cancer cells, altered large-nucleated cells with a thin membrane, a large amount of substance between the cells containing cartilaginous or hyaline connective tissue substances, histology diagnoses sarcoma. At the same time, the nodes lack normal cells characteristic of organ tissue.
• abnormalities in the chromosomes of oncological cells using the cytogenetic method.
• There are no specific blood tests for tumor markers, so there is no way to unambiguously determine its type.
• General blood test: for sarcoma will show the following abnormalities:

1. hemoglobin and red blood cell levels will decrease significantly (less than 100 g/l), which indicates anemia;
2. the level of leukocytes will increase slightly (above 9.0x109/l);
3. the platelet count will decrease (less than 150․109/l);
4. ESR will increase (above 15 mm/hour).

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

Diagnosis of sarcoma is complemented 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 is round or irregular in shape;
• the size of the formation in the mediastinum ranges from 2-3 mm to 10 cm or more;
• the structure of the sarcoma will be heterogeneous.

X-ray is necessary to detect pathology in lymph nodes: one or more. In this case, the lymph nodes on the x-ray will be darkened.

If sarcoma is diagnosed by ultrasound, it will be characteristic, for example:

• heterogeneous structure, uneven scalloped edges and lymph node damage - with lymphosarcoma in the peritoneum;
• 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. Nodes will be noticeable 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, unclear edges, effusion in the cavity of the joint capsule - with sarcoma of the joints.

Tumor markers for sarcoma are determined in each specific organ, as in cancer. For example, for ovarian cancer - for sarcoma of the breast - for gastrointestinal tract - CA 19-9 or lung - ProGRP (precursor of gastrin releasing peptide), etc.

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

Magnetic resonance imaging is performed to identify the exact size, metastases, destruction of the skin, bones, tissues, fibering of the periosteum, thickening of the joints, etc.

The diagnosis is confirmed by a biopsy and malignancy is determined 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, etc.

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

Do not remove:

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

The following treatment tactics are also used:

1. For 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. For highly differentiated sarcomas at stages 1-2, surgical treatment and extended lymph node dissection are performed. is performed before and after surgery, and in case of complex treatment it is added.
3. At the third stage of the oncological process, combined treatment is carried out: before surgery - radiation and chemotherapy to reduce the size of the tumor. During the operation, all growing tissues and regional lymphatic drainage collectors are removed. Restore important damaged structures: nerves and blood vessels.
4. Amputation is often required for sarcoma, especially osteosarcoma. Resection of the bone area is performed for poorly differentiated superficial osteosarcomas in older people. Next, prosthetics are performed.
5. At stage 4, symptomatic treatment is used: correction of anemia, detoxification and analgesic therapy. For comprehensive, complete treatment at the last stage, access to the tumor formation is required for the purpose of its removal, small size, location in the superficial layers of tissue, and single metastases.

Modern methods include external beam radiation therapy with linear accelerators using special programs that plan irradiation fields and calculate the power and dose of exposure to the oncological process area. Radiotherapy is carried out under full computerized control and automatic verification of the correctness of the settings specified on the accelerator control panel to eliminate human error. used for sarcomas of different locations. It precisely irradiates the tumor with a high dose of radiation without damaging healthy tissue. The source is inserted 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 part of complex therapy. For each type of sarcoma there is its own medicinal herb, mushrooms, resins, and food products. Diet during cancer is of great importance, since fortified foods and the presence of micro- and macroelements increase immunity, give strength to fight cancer cells, and prevent metastasis.

For malignant sarcomas, treatment is carried out:

• infusions;
• alcohol tinctures;
• decoctions;
• poultices.

Herbs used:

• black henbane;
• spotted hemlock;
• oxwort;
• cocklebur;
• white water lily;
• clematis;
• poppy samosa;
• sun milk,
• red fly agaric;
• knotty burrow;
• white mistletoe;
• incense pikulnik;
• evasive peony;
• European wormwood;
• common hop;
• common blackhead;
• greater celandine;
• saffron sativa;
• tall ash.

For old sarcoma ulcers on the skin and mucous membranes, treat with auranium officinalis, cutaneous sarcoma with wolfberry, sweet clover, cocklebur, kirkazon and clematis, milkweed and bittersweet nightshade, common tansy and European dodder, common hops and medicinal garlic ym.

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

• in the stomach - from wolfberry, black crow, datura and cocklebur, peony, greater celandine and wormwood;
• in the duodenum - from aconites, swamp whiteweed;
• 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, leftwort and common hop;
• in the uterus - from evasive peony, wormwood, Lobel's hellebore and saffron;
• in the lungs - from the magnificent crocus and cocklebur.

Osteogenic sarcoma is treated with a 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.

For 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: mix in equal weight fractions: tartar (flowers or leaves), calendula flowers, tricolor and field violet, cocklebur, chamomile flowers and speedwell, celandine and immortelle flowers, mistletoe and young burdock root. Brew 2 tbsp. l. collect 0.5-1 liters of boiling water and leave for 1 hour. Drink during the day.
2. Divide the herbs from the list into 2 groups (5 and 6 names each) and drink each collection for 8 days.

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

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

• Grind the 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, 1 tsp. with water (1 glass);
• Grind 100 g of marina root (peony evasive) and add vodka (1 l) or alcohol (75%), leave for 3 weeks. Take 0.5-1 tsp. 3 times with water;
• Grind the mistletoe, place it in a jar (1 liter) 1/3 full, fill it to the top with vodka and let it brew for 30 days. Separate the grounds and squeeze, drink 1 tsp. 3 times with water;
• chop meadowsweet root – 100 g and add vodka – 1 liter. Leave for 3 weeks. Drink 2-4 tsp. 3 times a day with water.

The first three tinctures should be alternated every 1-2 weeks. Meadowsweet tincture is used as a reserve. All tinctures are taken for the last time before the evening dinner. Course - 3 months, in the break between the monthly course (2 weeks) - drink 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, greens, fruits, fermented milk rich in bifido- and lactobacteria, boiled (steamed, stewed) meat, cereals as a source of complex carbohydrates, nuts, seeds, dried fruits, bran and sprouted cereals , wholemeal bread, cold-pressed vegetable oils.

To block metastases, the diet includes:

• 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, since they are stimulators of cancer cell division, as well as sources of glucose. Also products with tannin: persimmon, coffee, tea, bird cherry. Tannin, as a hemostatic agent, promotes thrombus formation. Smoked meats are excluded as sources of carcinogens. You should not drink alcohol or beer, the yeast of which feeds cancer cells with simple carbohydrates. Avoid acidic berries: lemons, lingonberries and cranberries, since cancer cells actively develop in an acidic environment.

Prognosis for life with sarcoma

The five-year survival rate for sarcoma of soft tissues and extremities can reach 75%, and up to 60% for cancer on the body.
In fact, even the most experienced doctor does not know how long people live with sarcoma. According to research, life expectancy for sarcoma is influenced by the forms and types, stages of the oncological process, and the general condition of the patient. With adequate treatment, a positive prognosis is possible for the most hopeless cases.

Disease Prevention

Primary prevention of sarcoma involves active identification of patients at increased risk of developing the disease, including those infected with herpes virus VIII (HHV-8). It is especially necessary to carefully monitor patients receiving. Prevention involves eliminating and treating the conditions and diseases that cause sarcoma.

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

After reading the article, be sure to study the positive experience of getting rid of stage 4 cancer. The technique we offer helps get rid of the cause of the disease, which guarantees the absence of exacerbations in the future.

Sarcomas are tumors that develop from poorly differentiated connective tissue cells. Although they are considered predominantly slow-growing and fairly treatable formations, the mortality rate from this disease reaches fifty percent.

To get rid of the disease at any stage, study how cancer appears and what needs to be done.Get rid of the disease in two months, as cancer survivors did

Cause of high mortality

Often the tumor is detected at a late stage, and the favorite location of metastases is the lungs. (This location is considered very dangerous, but we have successful experience in getting rid of metastases in the lungs at the last stage after ineffective treatment with chemotherapy and radiation).

Sarcoma is a cancer of the young. Very often this disease is diagnosed in adolescents and older children. As a rule, it is not painful at first and does not cause any particular inconvenience to the patient for a long time. Often the first symptoms that patients present with are general weakness, weight loss, fatigue - signs of cancer intoxication.

Tumors of mesenchyme (connective tissue) are quite diverse in origin and histological structure (angiosarcoma, liposarcoma, malignant mesenchioma, etc.).

Prognosis for sarcoma

The disease is distinguished by its degree of malignancy. Slightly necrotic tumors from highly differentiated cells with low mitotic activity grow more slowly, and the prognosis for their treatment is more favorable.

The prognosis also often depends on the origin of the disease, its location (most often in the lower extremities, but can also develop in the upper extremities, in the trunk, abdomen, neck) and growth rate.

Sarcomas are not the most common oncological diseases that respond well to treatment, but at the same time, these tumors are particularly prone to recurrence and metastasis to vital organs (lungs, liver).

Treatment of sarcoma

If you are lucky enough to detect the disease at an early stage, it is removed surgically. If the removed tumor is successfully located, all body functions are preserved and treatment does not lead to disability. However, very often after tumor removal there is malignant growth in the lungs. Metastases are also removed, but the five-year survival rate for this course of the disease is no more than 20%.

To reduce the number of relapses, courses of radiation and chemotherapy are necessarily used in complex treatment. With complex treatment, it is possible to achieve survival for five years after surgery in almost two thirds of patients. In other cases, the disease turns out to be stronger.

Let us emphasize: we are talking about survival for five years. Surviving for five years does not mean being cured of cancer. Relapses are usually inevitable because the cause of cancer remains unaffected. The cause of oncology is the death of cells of the autonomic nervous system (brain), which control the immune system - therefore, the immune system stops destroying cancer cells, they accumulate in the form of a tumor in the body.

To make it clearer how you can deal with this, let’s give an analogy: in stroke patients, as a result of the death of brain cells, for example, a hand can be paralyzed. Using a special technique, the cells of the cerebral cortex are trained in such patients so that these newly trained cells begin to control the hand. And then motor function of the hand is restored.

In the case of cancer, “paralysis” has occurred with the immune system, which means it is necessary to train the cells of the cerebral cortex to regulate this function. Immunity is restored, cancer disappears.

This physiological scheme is well understood by doctors, which is why there is a large percentage of physicians among our practitioners.

We are absolutely sure that neither chemotherapy, nor radiotherapy, nor surgery will revive the brain cells that control the immune system. Moreover, such procedures can finish them off completely, the person will die.

Infiltrative growth is a feature of the disease. Sarcoma belongs to the group of malignant tumors, the treatment of which is difficult due to the presence of:

Infiltrating tumor growth that destroys nearby tissues;
. frequent relapses after removal of sarcoma;
. rapid development of metastases spreading to the lungs or liver.

Sarcoma can develop without symptoms, and the general clinical picture is very similar to non-tumor diseases or benign tumors. Treatment of sarcoma requires a somewhat specific approach, which we will discuss in this article.

note

New technologies are coming to Russia.

We invite patients to participate in oncological diseases, as well as in clinical trials of T-cell-based drugs (LAK therapy). Therapy is carried out in various cancer research centers, depending on the type of tumor.

During the consultation the following will be discussed: - methods of innovative therapy;
- opportunities to participate in experimental therapy;
- how to get a quota for free treatment at the cancer center;
- organizational matters.
After consultation, the patient is assigned a day and time of arrival for treatment, a therapy department, and, if possible, an attending doctor is assigned.