Orthopedic Surgery

Soft Tissue Sarcomas

Soft tissue sarcomas are malignant tumors that begin in soft tissue, such as muscle, fibrous tissues, tendons, fat, nerves, joint tissues and blood vessels.

These tumors are rare and can form anywhere in the body. Usually, only about 900 cases of soft tissue sarcomas are reported per year in children in the United States.

Often painless, soft tissue sarcomas can be present in the body for a long period of time before they are discovered.

There are several types of soft tissue sarcomas that involve joints, bones and nerves. They include:

A few soft tissue sarcomas do not involve bones or joints. These include:

Studies have identified a connection between soft tissue sarcomas and other cancers. Certain conditions, such as inherited diseases like Li-Fraumeni syndrome or neurofibromatosis, as well as the infectious virus Epstein-Barr, have been linked to an increased risk of developing soft tissue sarcomas.

Cause of soft tissue sarcomas

The cause of soft tissue sarcomas is unknown, but there may be a genetic reason for their formation.

Symptoms of soft tissue sarcomas

Symptoms of soft tissue sarcomas include:

Diagnosing soft tissue sarcomas

Symptoms of soft tissue sarcomas can be difficult to identify in children, so regular check-ups are extremely important. Prompt diagnosis and identification of cancer as early as possible is crucial to overall treatment.

Diagnostic evaluation begins with a thorough medical history and physical examination of your child. A detailed neurological assessment may also be performed.

At The Children’s Hospital of Philadelphia, clinical experts use a variety of diagnostic tests to diagnose tumors, including:

Treatment for soft tissue sarcomas

Treatment for soft tissue sarcomas varies, depending on the location and size of the tumor. 

Surgery

Surgical treatment for soft tissue tumors may be used alone or in conjunction with chemotherapy or radiation therapy. 

Surgeries performed are typically:

In a wide resection with margins, the tumor is surgically removed, as well as some of the healthy tissue that surrounded the tumor — the margins of the tumor. In some cases, the child will need reconstructive surgery after the tumor has been cut out.

Reconstructive surgery

Reconstruction can include:

Limb-sparing surgery 

Surgical orthopedic and oncology specialists at CHOP are equipped to perform complex, limb-sparing surgeries for children with cancers like soft tissue sarcomas. CHOP surgeons are constantly pushing the envelope to improve upon existing surgical techniques, and improve outcomes for patients with even the most difficult-to-treat tumors. Learn more about limb-sparing surgery in the video below.

VIDEO APPEARS HERE
 

Surgical safety

Though surgery for soft tissue tumors is highly effective, we understand that any surgery can be a stressful experience for children and families. At CHOP, we offer a wealth of resources about how to prepare your child for surgery and what to expect during surgery.

Additionally, we employ numerous best practices before, during and after surgery to decrease the risk of infection and increase positive outcomes. For more details about safety protocols at The Children's Hospital of Philadelphia, see safety in surgery

Chemotherapy

Chemotherapy refers to medicines that help fight cancer. They are given by mouth, in the vein, in the muscle or under the skin. Intrathecal chemotherapy is chemotherapy that is injected into the spinal fluid to prevent or treat a malignant tumor in the brain and spinal cord.

Radiation therapy

Radiation therapy uses high-energy waves such as X-rays to kill or shrink cancer cells. It is sometimes used to treat cancer in the central nervous system or other places such as the eye or the testes.

Follow-up care for soft tissue sarcomas

Most children are able to go home shortly after surgery. They may require pain medications until the surgical site heals or ongoing physical therapy, but most are encouraged to resume their regular daily activities, like school, social events and play.

Your child will see the orthopedic surgeon about one to two weeks after surgery, then again at three and six months post-surgery. Annual monitoring by trained clinicians is strongly encouraged to monitor for possible reoccurrence of the growth.

Malignant tumors can reoccur — even after being successfully treated — so it is important for your child to see a physician regularly, especially if any symptoms reoccur.

During follow-up visits, X-rays and other diagnostic testing of the tumor site are recommended to closely monitor your child’s health and ensure there are no side effects from surgery, chemotherapy or radiation therapy.

Follow-up care and ongoing support and services are available at our Main Campus and throughout our CHOP Care Network. Our team is committed to partnering with parents and referring physicians to provide the most current, comprehensive and specialized care possible for your child.

Long-term outcomes for soft tissue sarcomas 

As with any cancer, survival depends on the type of cancer, the age of your child, how much the tumor has grown and how well your child tolerated treatment.

However, studies have shown that the younger your child is when diagnosed, the better the outcomes.

Resources

For more information about soft tissue sarcomas and malignant musculoskeletal tumors visit:

Contact us

To make an appointment with the Division of Orthopedic Surgery at The Children's Hospital of Philadelphia, call 215-590-1527 or contact us online.

 

Reviewed by: John P. Dormans, MD, FACS
Date: May 2013

  • Print
  • Share

Contact Us

Best in the Nation

CHOP ranked No. 1 children’s hospital by U.S.News & World Report and Parents magazine. Orthopedic Surgery at CHOP was spotlighted in both surveys. Learn more »

Working Together
to Help Your Child

CHOP's Division of Orthopedic Surgery works closely with the Cancer Center to diagnose and treat children with benign and malignant tumors. Learn more about the Cancer Center at CHOP.

Malcolm's Story

Eleven-year-old Malcolm had made the team for soccer camp when he started experiencing hip pain. The diagnosis? Ewing sarcoma. Read Malcolm's story »