Types of skin and soft tissue cancer

Any type of oncology requires immediate treatment. After all, the sooner you start therapy, the greater the chances of a complete recovery. The degree of development of the pathology is also of great importance.

Joint cancer is a neoplasm that affects connective tissue, affecting diarthrosis (the second name for joints). Based on the symptoms of joint cancer, there are about 30 types of this disease. Since the symptoms of joint cancers are generally similar, the treatment is the same in different cases. The prognosis for this disease is determined by what stage it has reached when doctors begin treatment.

Features of soft tissue tumors

Malignant soft tissue lesions are rare, accounting for no more than 1% of all cancers.
But the aggressiveness of many types of cancer of the skin or underlying tissues is very high. It is somewhat easier to identify them than lesions of internal organs, since they form quite noticeable changes in the color of the skin, its appearance or the density of the tissues under the epidermis. Sarcomas that affect soft tissue and are classified as malignant tumors can appear in the subcutaneous tissue, including stromal and fat cells, in muscle elements, blood vessels or lymphatic capillaries, nerve fibers, and connective tissue of joints. Localization of tumors is possible in any part of the body, but more than 50% of them affect the extremities (legs and arms), the rest are located in the neck and head, torso, less often internal organs or the retroperitoneal space are affected Source: Z.R. Khismatullina Skin neoplasms. Issues of epidemiology, classification, diagnostics // Creative surgery and oncology, 2010, pp. 69-73.

With early detection, radical removal of tumors and a favorable prognosis for recovery are possible.

Stages of development

Knee cancer develops in several stages. Doctors distinguish 4 stages. The success of the therapy and the choice of its method depend on the stage of development. The chances of a full recovery decrease as the tumor grows.

Let's describe each stage in more detail:

Initial. It has a low level of malignancy. The formation is localized inside the knee joint itself. It is classified according to the size of the tumor:

1A (new growth up to 8 cm);
2B (neoplasm larger than 8 cm).

The difference from the first is considered active development. Differentiation is lost and the degree of malignancy increases. The localization is the same (inside the knee joint). Metastases are not observed. Size classification is similar to the first stage.

Third stage

The third stage is characterized by a high level of malignancy. The formation spreads to the soft tissues around the joint. Characterized by the absence of metastases.

Fourth stage

The last stage is characterized by any degree of malignancy. The size of the tumor varies. There is a possibility of metastases penetrating to internal organs. There is a high probability of damage to the lungs and lymphatic system.

Zero stage

In addition to the stages listed above, doctors distinguish zero. This is the initial stage when the tumor is still absent. The stage is characterized by the appearance of one malignant cell. It is from this point that the entire neoplasm will begin to grow.

Types of soft tissue cancer

The most common type of skin cancer is basal cell carcinoma . This is a thickened area of skin that has a normal color or a pearly-waxy tint. Typically found in the arms, neck or head, up to 20% of lesions are found on the remaining parts of the body.

Another option for skin lesions is squamous cell carcinoma , which looks like a non-healing ulcer, spots with detachment of epithelial scales, and compacted reddened tubercles. The most common localization is the back and chest area, face or arms, neck, ears.

Another type - the most aggressive - is melanoma , a tumor that occurs in the area of moles (pigmented areas of the skin). It is characterized by rapid progression and high malignancy. Usually located in the interdigital spaces, in the groin, on the head, torso, and back.

Prognosis, possible complications

The outcome of the pathology in question, which occurs in the area of the knee joint, depends on the timing of detection of changes. If a malignant process is detected at stages 1 or 2, the probability of cure is quite high. But the chance of successful treatment also depends on the absence of damage to other parts of the body.

When starting therapeutic measures at stage 3, the likelihood of relapse in the near future increases. The prognosis in such situations cannot be called favorable.

The fourth stage is considered incurable. The number of deaths is high. All therapeutic measures are aimed only at making the patient feel better.

Signs

Typical signs of soft tissue cancer - sarcomas are found in the skin or underlying tissues. Initially, this is a painless lump, but as it grows, the nerves become irritated and discomfort occurs. Tumors larger than 40-50 mm with penetration deep into tissues are especially dangerous. The most common types of sarcoma:

Tumor of adipose tissue - liposarcoma. Typical of the knees, retroperitoneum and thighs.
Formations from skeletal muscles - rhabdomyosarcomas. They affect the muscles involved in motor acts.
Fibrosarcomas are neoplasms of connective tissue. Typically appear between muscle fibers in the shoulders, hips or neck.
Synovial sarcomas affect the membranes of large joints in the arms and legs.
Leiomyosarcoma occurs in the area of smooth muscle elements of hollow organs - the small intestine, uterus, bladder or stomach.
Different types of nerve cell sarcomas arise in the area of nerve trunks. These are neuromas, sympathoblastomas or schwannomas.
A rare type of cancer that is prone to rapid metastasis is hemangiosarcoma , it damages the walls of blood vessels.
An extremely rare type of lymphangiosarcoma damages the lymphatic ducts and capillaries. Typical for women who, for some reason, had a mastectomy (the mammary gland was removed) Source: L.N. Vashchenko, T.V. Ausheva, E.L. Ibragimova, E.M. Nepomnyashchaya Some clinical issues of soft tissue sarcomas // News of higher educational institutions. North Caucasus region. Natural Sciences, 2013.

Why do soft tissue and skin tumors occur?

For various types of skin cancer, UV radiation is considered a key trigger. Prolonged exposure to the open sun, aggressive tanning, and sunburn provoke epithelial and pigment cells to cancerous transformation. This is especially dangerous for fair-skinned people, residents of high mountains and those who have many moles and nevi on their bodies.

For all tumors in general, provocateurs can be:

Ionizing radiation accounts for up to 5% of cancer. Radiation for the treatment of other types of tumors (lymphoma, breast cancer) is also dangerous. In general, up to 10 years pass between radiotherapy and the formation of sarcomas.
Unfavorable heredity for melanoma or sarcoma, as well as the presence of certain genetic pathologies, for example, neurofibromatosis - the formation of multiple fibromas on the body, which can develop into cancer.
Gardner's syndrome is dangerous in terms of the development of soft tissue tumors. It develops polyposis or intestinal cancer, as well as fibrosarcomas or tumors of other localizations.
Provocateurs of cancerous tumors can be frequent injuries to soft tissues, extensive surgical interventions, and the presence of various structures in the body - knitting needles, plates.
Possible influence of various chemical carcinogens that damage cells. As a result, DNA suffers and may develop into cancer.
The presence of precancerous conditions and benign tumors in some situations can lead to their transformation into cancer, for example, with leiomyoma or uterine rhabdomyoma.

Symptoms

The symptoms of knee cancer depend on the degree of malignancy of the tumor and the stage of the disease.

Chondroma, as a benign tumor that does not pose a serious danger if treated in a timely manner, is mainly determined by the deformation of the affected area.

The knee begins to increase in size, and there are clear differences between the right and left legs. Moreover, if the chondroma has not yet developed significantly, then it may not even cause pain, so you should consult a doctor only if external signs appear.

As the chondroma grows, its manifestation becomes stronger: pain appears, and the greater the deformity becomes, the greater the risk of limb fracture.

A cancerous tumor at the first and second stages is characterized by minor painful sensations that do not have a specific localization.

That is, a person feels paroxysmal pain in the leg during active movements or bending of the knee, but he cannot clearly determine where exactly it hurts. As the tumor develops, the pain begins to localize in the knee area, and its intensity increases. In most cases, medical painkillers do not bring the desired result.

At the third or fourth stage of knee cancer, the connective tissue begins to deform - the tumor is detected by its characteristic external signs. Significant swelling of the affected area appears, the neoplasm can be easily felt during palpation (this research method can cause severe pain).

Also, late stages are accompanied by accompanying symptoms:

significant increase temperature ;
malaise, general weakness;
loss of a large amount weight ;
decreased appetite;
pressure surges headaches, fainting.

Signs of skin tumors and soft tissue oncology

People usually notice the first symptoms of skin cancer in the arms or legs, and less often in the chest and back. Often the appearance of an unusual mole or tumor area is preceded by sunburn, injury or intense exposure (calluses, abrasions). Often tumors appear on scarred tissue, leading to the formation of bumps, ulcers, peeling skin or uneven pigmentation.

A number of signs are typical for melanoma - ABCDE gradation, which distinguish it from all others:

A (from the English asymmetry) – asymmetrical edges of the mole;
B (from the English boundary) – uneven, torn edges, teeth;
C (from the English color) – the coloring of the element is uneven, with areas of light and almost black, bluish inclusions;
D (from the English diameter) – growth of more than 50-60 mm in diameter;
E (from the English evolution) - a rapid change in the appearance of a mole within a short time.

Soft tissue sarcomas may not produce pronounced symptoms for a long time until they reach large sizes and begin to compress blood vessels and nerves. There are signs of neuralgia, a crawling sensation, pain, numbness. There may be general malaise, weight loss, loss of strength, a tumor-like uneven compaction without clear edges is found under the skin. It can move relative to the tissues or be motionless, very hard. Non-healing ulcers may develop on the surface of the nodes.

If these are tumors of muscles or joints, ligaments, pain during movement is typical for them, but it can be insignificant and often the cancer is diagnosed at a late stage, when there are already metastases.

Prevention

The most effective preventive measure for any cancer is regular medical examination. examination of the body. Recommended once every 6 months. undergoes inspection by all specialists. This approach will allow timely detection of cell mutations. This means that measures to remove them will be carried out on time.

Doctors focus on regular examinations of those people who are at risk. To find out whether you may have cancer of the knee joint, go through all the necessary studies and take the prescribed tests. It is better to prevent the development of cancer than to treat it later.

Diagnostic features

The basis for diagnosing soft tissue tumors is the patient’s complaints, changes in the appearance of moles or underlying tissues. In order to clarify the nature of the tumor, its type and degree of malignancy, and draw up a treatment plan, it is necessary:

Dermatoscopy is the study of the epidermis using a modern dermatoscopy device with illumination and optics.
A biopsy is taken to determine the cell type.
Radiography to determine bone and soft tissue damage in different types of sarcomas.
Ultrasound to detect tumors in soft tissues and organs.
MRI or CT scan to clarify the size, presence of metastases in lymph nodes or distant organs.
Angiography, including with contrast to detect vascular tumors.
These methods are complemented by blood and urine tests, testing for tumor markers, as well as histological, biochemical and cytological analyzes of tissue samples obtained during biopsy Source: A.A. Modestov, E.V. Semenov, R.A. Zukov, E.V. Slepov, E.N. Eremina, E.N. Gaas New approaches to organizing screening for malignant skin tumors. Siberian Journal of Oncology, 2021, No. 16(2), pp.61-65.

Treatment of soft tissue cancer

The main method of treating cancer of the skin and underlying tissues is surgical excision of the tumor within healthy tissue. If the formation is large, additional plastic surgery is performed to improve the appearance. In some cases, it is also necessary to remove regional lymph nodes.

If the tumor is inoperable or it is necessary to reduce its size before surgery, chemotherapy is prescribed with modern drugs with minimal side effects and influence on the body. It is possible to use drugs after surgery to destroy remaining cancer cells and prevent relapses.

Targeted therapy protocols have been developed for melanoma, targeting only cancer cells with special monoclonal antibodies. Methods of immunotherapy for skin cancer are used with the introduction of drugs in courses to activate one’s own immune system to fight cancer Source: Paulson KG, Lahman MC, Chapuis AG, Brownell I Immunotherapy for skin cancer // Int Immunol. 2021 Jul 13;31(7):465-475. doi: 10.1093/intimm/dxz012.