Types of Sarcoma

Sarcoma is a general term for a type of rare cancers that can affect adults, teenagers and children. Because these tumors are complex and uncommon, they require highly specialized and personalized care.

A high-volume cancer center, Tampa General Hospital’s Cancer Institute boasts a dedicated Sarcoma Center of Excellence, which offers the latest options for diagnosing and treating all types of sarcoma, including those that are exceedingly rare. We take an individualized approach to cancer care, helping each patient find the right treatment plan to ensure the best possible outcome and quality of life.

A proud member of the U.S. News & World Report “honor roll” of cancer centers in the United States, TGH has earned the “High Performing in Cancer” designation for 2023-24. U.S. News & World Report’s ranking of hospitals and specialties is highly influential and often cited in grading the level of care offered by hospitals across the nation.

What Is Sarcoma?

Sarcoma is a family of rare cancers that originate in soft tissues or bones. Soft tissue sarcoma develops in tissues that connect, support or surround organs and other bodily structures, such as muscles, tendons, ligaments, cartilage, blood vessels, nerves and fat. Bone sarcoma develops in bones.

To date, scientists have identified more than 70 types of soft tissue and bone sarcoma. Each tumor is categorized based on its site of origin, the appearance and behavior of its cells when viewed under a microscope and its cause (if known).

Common Types of Soft Tissue Sarcoma

Soft tissue sarcoma most often develops in the arm, leg or trunk. The specific types include:

  • Angiosarcoma (vascular sarcoma) – Develops in the cells that line blood vessels and lymph vessels, usually on the surface of the skin
  • Clear cell sarcoma – Develops in the deep soft tissues that surround the muscles and tendons in the lower leg and foot
  • Dermatofibrosarcoma protuberans (DFSP) – Develops in the connective tissue cells in the middle layer of skin (dermis)
  • Epithelioid sarcoma – Develops under the skin of the forearm, hand, fingers, lower leg and foot
  • Gastrointestinal stromal tumor (GIST) – Develops in the cells that line the digestive tract, most often in the stomach
  • Kaposi sarcoma – Develops in the cells that line blood vessels and lymph vessels, usually in the skin, genitals and mouth
  • Leiomyosarcoma – Develops in the smooth muscles that line the hollow organs in the abdomen and pelvis, such as the stomach, bladder and uterus
  • Liposarcoma – Develops in fatty tissues
  • Myeloid sarcoma – A blood cancer that develops in soft tissues instead of bone marrow
  • Pleomorphic sarcoma – Develops in soft tissues in the arm, leg and area behind the abdominal organs (retroperitoneum)
  • Rhabdomyosarcoma – Develops in the cells that normally form skeletal muscles
  • Synovial sarcoma – Develops in the membrane that lines articulated joints (synovium)
  • Uterine sarcoma – Develops in the muscles and other connective tissues that support the uterus
  • Desmoid Tumors – Rare, noncancerous growths that develop in the connective tissue, often requiring careful management due to their potential impact on surrounding structures

Common Types of Bone Sarcoma

    Bone sarcoma primarily affects teenagers and often develops in areas where bones are still growing. Common sites include the lower thighbone (distal femur), upper shinbone (proximal tibia) and upper arm bone (proximal humerus). The specific types include:

  • Chondrosarcoma – Develops in the bones in the hip, pelvis and shoulder
  • Ewing sarcoma – Develops in the bones in the pelvis and leg
  • Fibrosarcoma (fibroblastic sarcoma) – Develops in the bones in the arm and lower leg
  • Osteosarcoma – Develops in the long bones around the knee
  • Spindle cell sarcoma – Develops in the long bones in the arm and leg

Sarcoma Causes

Sarcoma begins when immature soft tissue cells or bone cells undergo harmful changes that damage their DNA. Normally, DNA regulates cellular reproduction by providing precise instructions on when the cell should grow, divide and die. Damaged DNA can provide faulty instructions that cause the cell to replicate uncontrollably. Excess abnormal cells can then build up, bind together and form tumors.

If left untreated, sarcoma can grow and invade nearby healthy tissues. Additionally, if cancerous cells enter the lymphatic system or bloodstream, they can circulate throughout the body and spread (metastasize) to distant organs and tissues.

Through extensive research studies, scientists continue to learn more about the causes of cancer in general and specifically sarcoma. However, the exact triggers of the DNA changes that lead to the development of sarcoma are not yet fully understood.

Sarcoma Symptoms

Sarcoma can develop in various tissues and locations throughout the body. As such, the symptoms can vary widely and may not be noticeable in the early stages of malignancy. In some cases, the first sign is a lump that can be felt under the skin. A growing lump is a red flag that warrants prompt evaluation by a physician.

Other possible signs of a soft tissue sarcoma include:

  • Abdominal pain and bloating
  • A persistent feeling of fullness (satiety)
  • Difficulty walking
  • Constipation
  • Blackened or bloody stools
  • Chronic coughing
  • Shortness of breath
  • Chest pain

In addition to a lump, a bone sarcoma may cause:

  • Persistent bone pain
  • Frequent fractures with minimal or no trauma
  • Difficulty moving an arm or leg
  • Limping or gait changes
  • Back pain
  • Swelling in an arm or leg that worsens at night
  • Skin redness and warmth
  • Anemia
  • Unintended weight loss
  • Unexplained fatigue

In children, bone sarcoma often develops around the knee and may be misattributed to “growing pains,” which can delay the diagnosis.

Sarcoma Diagnosis

Typically, the diagnostic process for sarcoma begins with a thorough medical history review and physical examination. From there, the physician may order a series of imaging tests, such as:

A biopsy is the only test that can be used to conclusively diagnose sarcoma. This procedure involves removing a small sample of suspicious tissue for microscopic evaluation by a pathologist. If the pathologist identifies sarcoma, they will perform further testing to determine its subtype, which is an important consideration when planning treatment.

Sarcoma Treatment

Sarcoma treatment can vary depending on several factors, including the type of sarcoma, the size and location of the tumor, the patient’s overall health and whether the sarcoma is newly diagnosed or recurrent. Common treatment options include:

Benefit From World-Class Care at TGH Cancer Institute

The multidisciplinary team in TGH Cancer Institute’s Sarcoma Center of Excellence is widely known and respected for having extensive expertise in diagnosing and treating all types of sarcoma. If you would like to learn more, contact us at (813) 844-4151 to request an appointment with a sarcoma specialist.