Sarcomas are found on the limbs much more often than in other organs and parts of the body. And in most clinical cases, the sarcoma affects only one limb.
Sarcoma has all the signs typical of other malignant formations - it grows into neighboring structures, destroys them, is prone to recurrence, lets metastases into lung tissue, liver and other organs.
Often the original localization in metastasis does not play a special role, even the foot sarcoma can penetrate the lungs, which, in fact, will be discussed further.
Varieties and localization of
Sarcomatous tumors of the lower limbs can be formed from soft tissue or bone structures and are localized in the tissues of the hip, thigh or soft tissues, the knee joint, the foot or the shin, etc.
Generally, sarcomatous leg formations are formed from muscle, vascular,articular, tendon, fat and other cellular structures.
Similar formations are divided into:
- Osteosarcoma - footed formations;
- Chondrosarcomas - are formed from cartilaginous tissues;
- Fibrosarcomas - are formed from connective tissue and fibrous elements;
- Ewing's sarcoma - localized in the extremities of the long bones of the legs( and arms);
- Angiosarcomas - are formed from blood-vascular elements;
- Liposarcomas are formed from adipose tissue cells;
- Synovial tumor - is formed from the synovial membranes of the articular structures;
- Dermatofibrosarcoma - formed from connective tissue elements and skin structures;
- Lymphosarcomas are formed from lymph nodes.
Photo of bone osteosarcoma of foot
For sarcomatous tumors, typically rapid and sometimes explosive development of a tumor, this feature is especially noticeable in children's tumors.
Causes of pathology
There are no specific and specific reasons for the occurrence of sarcomatous formations in the limbs, but there are provoking factors contributing to their appearance. These are:
- Ultraviolet exposure for prolonged exposure to the sun or in the solarium;
- Ionizing radiation exposure( radiotherapy);
- Genetic predisposition to pathology, the presence of hereditary chromosomal pathologies;
- High radiation background;
- Blood infections and viral effects such as herpes, immunodeficiency or papillomavirus;
- Presence of a precancer, benign tumor processes;
- Employment in hazardous production, such as an oil refinery or a chemical plant;
- Pathologically low immune status leading to the development of autoimmune conditions;
- Hormonal disorders in adolescence, causing intensive growth of bone structures;
- Carcinogenic effects on the body( asbestos, nickel or cobalt);
- Nicotine addiction for more than 10 years.
Symptoms of foot sarcoma
The clinical picture of sarcomatous leg formations depends on a variety of factors, such as histological features, degree of development and specific localization. But they also have much in common, for example, such formations are often accompanied by general-type symptoms such as malaise, weakness and exhaustion.
Similar tumors are capable of developing their own vasculature, which causes a shortage of nutrition and oxygen in other organic structures.
Hip Joint
Similar localization of sarcomatous formation is more often found in male patients of any age and has an excessive malignancy index.
Such formations are characterized by rapid progression, early metastasis, high malignancy and extremely aggressive course.
Such a tumor is difficult to diagnose at the initial stages, but with the development of the process of growth, the symptoms become more pronounced.
- There are painful sensations that gradually increase and intensify intensity, with the growth of the tumor pains bring a lot of discomfort, do not stop anesthetics and reduce the quality of life.
- If the formation is formed shallow, then in the region of the hip joint, a slight protrusion can be seen.
- With the growth of education there is a shift and compression of surrounding tissues, there is a violation of their functions and clamping of blood vessels.
- In accordance with the location of the affected nerve nodes pain symptoms occur not only in the hip joint, but also radiates to the thigh, genitals and adjacent structures.
- In the hip joint painful contractures are formed, the joint mobility is disrupted.
- With the development of education gives the strongest pain, especially at night. Analgesics to ease pain are not capable.
Hip sarcomas are characterized by extensive metastasis by the hematogenous way into pulmonary, cerebrospinal and other body structures.
Thighs
The femoral sarcomatous tumor can have both an independent origin and a metastatic tumor. But most often this kind of formation occurs due to metastasis from the low-tidal structures, sacrococcygeal zone, parts of the genitourinary system, etc. More often in the thigh tumors of Ewing or osteosarcoma are formed.
Femoral sarcomatous formations are quite widespread. Gradually, tumor processes spread to the joint fractions of the hip and knee localization, surrounding soft tissue structures.
Gradually, the tumor grows and clamps the vascular beds, which can cause the pale legs and feel cold in them.
Later on the extremities are ulcerative lesions, there are violations of trophism and severe swelling, develops venous congestion. There is a short-term hyperthermia, causeless weight loss, lack of appetite, sluggish and weakened state of health, a constant feeling of fatigue.
Knee joint
The sarcomatous knee-joint tumor is usually of metastatic origin, resulting from the spread of the tumor from the primary focus.
Often, metastases come from pelvic structures or popliteal lymph nodes.
Since knee-joint tissues contain both bone and cartilaginous elements, they can form osteogenic or chondrosarcoma tumors that manifest themselves with such symptoms:
- Knee disorders occur abruptly;
- Motor abilities are disrupted;
- There is soreness;
- In the external direction of tumor growth, the sarcoma begins to appear visually, it is felt during palpation, and the skin on the knee changes;
- Tumor processes often damage ligamentous tendon tissue, which also leads to functional limb disorders;
- With further development, there is damage to the joint tissues, which leads to the impossibility of resting on the leg and depriving the knee of any motor abilities;
- The tumor grows, the vascular and neural canals survive, which contributes to the greater spread of the pain syndrome, causes hypertension and a deficiency in the supply of leg tissues.
Shins
In the tissues of the shin, sarcomatous formations of osteogenic or soft tissue type may also occur.
Pain symptomatology in the osteosarcoma of the shin occurs at rather late stages, when there is a pinching of the neurovascular channels. Then the pain is felt in the foot and fingers, skin trophic changes occur, edema of the diseased limb is lower than the formation.
If the tumor is localized on the front wall, then it can be palpated already in the early stages, with posterior localization it can for a long time grow hidden in the thickness of the calf muscles.
With the development of pathology, the clinical picture is supplemented by symptoms such as anemia, hyperthermia, weight loss, weakness and other oncological symptoms. The toes stop normal movement, lose sensitivity, there are violations of trophism and swelling.
Feet of the
Sarcomatum neoplasm of the foot, like the tibia, may be osteogenic or soft tissue.
Bone formations are detected early, almost immediately causing severe soreness, structural disorders in the bone and surrounding tissues. In complicated cases, the tumor spreads to the ankle joint, causing pain and motor limitations.
Soft-tissue foot swelling also appears early, as they have nowhere to grow and are noticeably visually. Usually, a hemorrhage appears over the tumor, the skin tone changes, and the motor function is disrupted.
Diagnostics
Diagnostic process is based on an integrated approach, the patient is assigned:
- Positron emission tomography;
- MRI;
- Biopsy and histological examination of biomaterial;
- Extended laboratory blood tests;
- Radioisotope diagnostics;
- Consultation and examination of the onco orthopedist.
An important role is given to staging, because the treatment prognosis depends on the prevalence of the tumor process and the presence of metastases.
Methods of treatment of patients with
The underlying technique of treatment is surgical operation. Usually it consists in resection of the affected area.
The patient is carefully examined for the presence of metastasis in the lymph nodes and other structures of the body.
If secondary sarcomatous foci are found during the examination, they are also removed, after which the patient is prescribed chemotherapy.
Antineoplastic drugs are selected individually, taking into account the purpose of exposure. Preoperative chemotherapy is performed to reduce the size of the formation, and postoperative chemotherapy to destroy the possible remaining micrometastases.
Forecast
Timely detection and surgical treatment most often provides full recovery, however, the patient needs orthopedic correction.
Sarkomatous tumors of such a localization often metastasize into the pulmonary structures, so it is impossible to cure such a patient. Then the patient is shown palliative therapy, which makes it easier to feel well and eliminates some manifestations of the oncology process, which positively affects the quality of life of the oncology patient.
A video story of a patient who underwent an organ-saving operation to remove osteogenic sarcoma of the knee joint: