Sarcomas de partes moles nos membros, mais comuns e tão graves quanto os sarcomas ósseos

Abstract

ResumoOs sarcomas musculoesqueléticos são doenças raras que exigem atenção. Frequentemente, apresentam alto grau de malignidade ao diagnóstico e se subestimados podem evoluir de forma agressiva local e sistemicamente. Apresentam-se como sarcoma de partes moles e sarcomas ósseos, sendo os de partes moles quatro a cinco vezes mais comuns. A maioria dos sarcomas de partes moles ocorre nos membros. Os subtipos mais comuns nas crianças e adolescentes são o rabdomiossarcoma e o sarcoma sinovial, nos adultos o sarcoma pleomórfico indiferenciado, lipossarcoma, leiomiossarcoma, mixofibrossarcoma e sarcoma sinovial; todos de alto grau de malignidade histológica. Muitos sarcomas de partes moles são confundidos com tumores benignos de partes moles, 100 vezes mais comuns, por isso são ressecados sem o planejamento necessário, acarretando em amputação de um membro que poderia ter sido preservado. Como em todos os cânceres, o fator prognóstico mais importante é a doença metastática. Na sua vigência, a taxa de sobrevida global cai em torno de 20 a 30%. As taxas de sobrevida no geral são parecidas entre os sarcomas ósseos e de partes moles, portanto o sarcoma de partes moles, além de mais prevalente, mostra-se tão agressivo quanto os sarcomas ósseos, por isso merece muita atenção dos ortopedistas que frequentemente são a primeira linha de atendimento dos portadores destes tumores.

From standard therapies to monoclonal antibodies and immune checkpoint inhibitors – an update for reconstructive surgeons on common oncological cases

“…STS encompass a range of mesenchymal malignancies originating from muscles, adipose tissue, tendons, and vasculature structures. They predominantly occur in the extremities ( 143 – 145 ). Among children and adolescents, rhabdomyosarcoma (RMS) and synovial sarcoma are the most frequent subtypes, whereas liposarcoma (LS) and leiomyosarcoma (LMS) are the most common STS observed in adults.…”

“…Among children and adolescents, rhabdomyosarcoma (RMS) and synovial sarcoma are the most frequent subtypes, whereas liposarcoma (LS) and leiomyosarcoma (LMS) are the most common STS observed in adults. Based on prevalence rates, this review will focus on RMS, LS, and LMS ( 143 , 144 ). RMS is categorized into distinct clinical subtypes based on histopathological features including embryonal RMS (ERMS), alveolar RMS (ARMS), pleomorphic RMS, and spindle cell/sclerosing RMS (ssRMS).…”

Management of chemotherapy-induced febrile neutropenia and use of granulocyte colony-stimulating factor in patients with soft tissue or bone sarcoma

“…Bone sarcomas are even rarer and account for 0.2% of cancer cases. [1][2][3] The treatment of sarcomas includes different approaches, such as radiotherapy and chemotherapy. Adjuvant, neoadjuvant, or palliative chemotherapy can trigger several adverse events.…”

A Method for Intraoperative Decompression of Large Soft Tissue Tumors to Facilitate En Bloc Resection

“…1 Although relatively rare, accounting for <1% of all malignant tumors, ∼10% of patients have metastasis present at diagnosis and nearly 50% of the patients with STS will ultimately develop distant metastases. 2 Treatment with curative intent of STSs consists of wide resection with negative margins and typically neoadjuvant and/or adjuvant radiation therapy to decrease the risk of local recurrence. While the average size of a STS at presentation is 10 cm, ∼10% of patients present with large tumors that are > 20 cm.…”

“…Soft tissue sarcomas (STSs) comprise a heterogenous group of rare and aggressive tumors arising from mesenchymal tissues that can occur anywhere in the body 1. Although relatively rare, accounting for <1% of all malignant tumors, ∼10% of patients have metastasis present at diagnosis and nearly 50% of the patients with STS will ultimately develop distant metastases 2. Treatment with curative intent of STSs consists of wide resection with negative margins and typically neoadjuvant and/or adjuvant radiation therapy to decrease the risk of local recurrence.…”