Soft tissue sarcoma comprise a heterogeneous group of mesenchymal tumors which has potential for metastasis and recurrence if not detected early. Usually they present as extremity swelling and history of trauma is commonly elicited. Trauma is not the causative factor in most of the cases and it merely draws the attention to the site of swelling. Commonly seen in elderly individual, except few who present in the teenage group.
Most of the soft tissue sarcoma don’t have any known predisposing factor. Certain tumors may have genetic causes, induced by mutated genes present in an individual. In genetic disorders, other disease manifestation may be present and sarcomas in genetically predisposed may occur at younger age than usual. Lymphedema i.e swelling occurring in limbs due to lymphatic obstruction is common factor found. Previous history of radiation has also be a predisposing factor for sarcoma. Trauma may by rigorous exercise or after delivery has been found to predispose to sarcoma, strong evidence in favor of trauma as a causative factor for sarcoma has not been found.
CT scan or MRI of the affected limb is required to know the local extent of the disease, along with this CT scan of chest and abdomen may be required for the assessment of the metastatic disease. Biopsy is done by core-cut needle for assessment of type and grade of the tumor. Biopsy should be within the confines of the planned excision of the skin so that it comes along with complete excision of the tumor.
Complete surgical excision remains the corner stone for the treatment of soft tissue sarcoma. Now with the advent of effective chemotherapy and radiation it is possible to reduce the size of the tumor and to effectively perform limb salvage surgery. Early stage tumors 5 – year survival approaches almost 85%. For advanced stage or metastatic it is almost no survival.