image of a doctor comforting a patient with soft tissue sarcomas

While soft tissue sarcomas can occasionally form in bones, they usually develop in fat, muscle, nerves, tendons, joint linings, or blood or lymph vessels—the tissues that connect, support, and surround other body parts and organs.

These rare tumors grow almost anywhere in the body, but in adults are usually found in the head, neck, arms, legs, trunk, or abdomen. The most common occurrences in children are found in the arms, legs, chest, or abdomen.

Our team of physicians has years of experience treating people with cancer. You can also benefit from our multidisciplinary approach, which allows us to collaborate with experts in a variety of fields, including: 

  • Fellowship-trained surgical oncologists

  • Medical oncologists

  • Radiation therapists

  • Diagnostic imaging technicians

  • Pathologists

In addition, we use the most cutting-edge research to guide your care. That means you have access to the latest cancer clinical trials and the most innovative ways to treat your disease.

We treat every one of our patients in the Jesuit spirit of cura personalis, which means caring for the entire person. Everyone on our staff will offer you and your family kindness, compassion, and respect throughout your time with us.

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Types of soft tissue sarcoma

More than 50 types have been identified. These include:

  • Alveolar Soft part sarcomas: Rare, slow-growing tumors that mainly affect teens and often grow deep in the thigh, though they can show up in the heads and necks of younger children

  • Clear cell sarcomas: Mainly affect younger adults ages 20 to 40, growing just beneath the skin and affecting tendons and muscle sheaths—usually in the foot and ankle

  • Epithelioid sarcomas: Mainly develop in the forearm or hand, most frequently in male patients in their teens or 20s

  • Fibrosarcomas: Develop from the tissues keeping bones, organs, and muscles secure. One type of the disease mainly affects middle-age adults, usually in the legs, arms, or trunk. The other type affects children—most frequently at birth and almost never past age 2. Outcomes are better for children, with a lower chance the cancer will spread or return.

  • Gastrointestinal stromal tumors (GIST): Rare tumors that tend to affect adults; they develop in the abdomen, where they can grow quite large before being noticed, which can make them harder to remove

  • Leiomyosarcomas: Develop from blood vessels in the trunk and limbs; mainly affect adults starting in middle age

  • Liposarcomas: Develop from fatty tissues and usually appear in the arms, legs, abdomen, or buttocks—most frequently in men and women over 50

  • Rhabdomyosarcomas: Made of cells that normally develop into the skeletal muscles we use to control our body and found mainly in the head and neck, urinary and reproductive organs, arms and legs, and trunk. While the tumors can affect all ages, they’re mainly found in children under 5 and are the most common childhood soft tissue sarcoma. They can grow quite large in a short period of time.

  • Synovial sarcomas: Develop deep in the muscles of the arms and legs and mainly affect young adults, particularly men in their 30s

Read more about sarcomas

Risk factors

Soft tissue sarcoma is not a common type of cancer—it accounts for about 10,000 cases per year. While we don’t know what causes most soft tissue sarcomas, several risk factors exist:

  • Inherited disorders

    • Retinoblastoma

    • Neurofibromatosis (von Recklinghausen disease)

    • Tuberous sclerosis (Bourneville disease)

    • Gardner syndrome

    • Li-Fraumeni syndrome

    • Werner syndrome

    • Gorlin syndrome (Nevoid basal cell carcinoma syndrome)

  • Past radiation therapy for certain cancers

  • Chronic swelling in the arms or legs (tied to some lymph vessel cancers in adults)

  • Extensive exposure to certain chemicals, including Thorotrast, vinyl chloride, or arsenic

Symptoms

A sarcoma may cause a painless lump under the skin (usually on the arms, legs, or trunk), but often no other symptoms exist at first. As the sarcomas grow and press on organs, nerves, muscles, or blood vessels, they can cause:

  • Pain
  • Breathing trouble
  • Abdominal swelling (or distension)

These symptoms can indicate a variety of different problems. Make sure to discuss any that you experience with your doctor, especially if you also have risk factors for soft tissue sarcoma.

Screening and prevention

Successful treatment depends on a complete and accurate diagnosis. Each of our patients receives a thorough evaluation so we can create an individualized plan. Screening for bone sarcomas includes:

  • Medical history: We will discuss your symptoms and medical history, including whether you suffer from any of the soft tissue sarcoma risk factors

  • Physical examination: We will examine you thoroughly, including any lumps you have

  • Blood work

  • Imaging scans: A variety of imaging scans can help identify the presence, type, and size of a soft tissue sarcoma, including:

    • X-ray

    • CT (CAT) scan: This imaging test uses X-ray technology and computers to create a detailed picture of your affected tissues

    • MRI: This imaging test uses high powered magnets to create a picture of the affected area

    • PET scan: For this imaging test, your doctor injects a radioactive glucose. The PET scan follows the glucose's path, which identifies the presence of cancerous cells

    • Bone scan

  • Biopsy: Your surgical oncologist will determine whether you need this procedure. If you do, your radiologist will remove tissue from your affected area for closer examination under a microscope. This will help determine whether you have cancerous cells and how quickly the cells are spreading

Sarcomas are very rare and we don’t yet have a specific prevention strategy for this type of cancer, but research is ongoing.

Treatment

Treatment depends on what type of disease you have, whether it has spread to other parts of your body, and where the tumor is located. Treatment options include:

  • Surgery: This treatment removes as much of the tumor as possible, as well as some surrounding healthy tissue. This is called complete margin-negative resection

  • Chemotherapy: This treatment can destroy some, but not all types of soft tissue sarcomas. It uses powerful drugs delivered either orally or through your veins (IV)

  • Radiation: This treatment uses high-energy radiation beams to destroy the tumor and cancerous cells. Your sarcoma team will discuss with you whether this option is appropriate for your disease. If it is, make sure you understand the pros and cons of receiving radiation before or after surgery

We give each patient a thorough evaluation to determine the best recommendation. Children and teens may respond to treatment differently than adults and often have a better prognosis. We’re also working to safely lower the amount of radiation and chemotherapy younger patients receive while still providing successful cancer treatment.

Read a blog post about sarcoma treatment.

Learn more about treating soft-tissue sarcoma.

Follow-up care

Following treatment, you will meet with our surgical oncologists on a regular basis to monitor your progress. This may include repeating some of the diagnostic tests and imaging scans. These tumors can recur, or reappear, even after treatment. We will work with you to make sure we catch any recurrence as early as possible. Factors that can affect recurrences include:

  • Size: A large sarcoma size has a higher chance of recurring.

  • Grade: Low grade sarcomas are less likely to recur

  • Location: Sarcomas that affect the inside of the abdomen and the organs around it are more likely to recur that those that affect the limbs

  • How much was surgically removed: If your surgical oncologist was unable to completely remove the sarcoma, you may be more likely to have a recurrence. Sometimes the location of the sarcoma does not allow for a complete removal. In those cases, we will follow-up surgery with radiotherapy

  • Previous recurrence: A sarcoma that has already recurred is more likely to recur again

  • Type of histology: The specific details of the tissue that make up your sarcoma

  • Your age: If you are older, it is more likely for the sarcoma to recur

Learn more about diagnosis and care of sarcomas and related tumors:

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