What are soft-tissue tumors?

Updated: Dec 03, 2018
  • Author: Vinod B Shidham, MD, FRCPath; Chief Editor: Omohodion (Odion) Binitie, MD  more...
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Answer

Soft tissue is defined as the supportive tissue of various organs and the nonepithelial, extraskeletal structures exclusive of lymphohematopoietic tissues. It includes fibrous connective tissue, adipose tissue, skeletal muscle, blood/lymph vessels, and the peripheral nervous system. Embryologically, most of it is derived from mesoderm, with a neuroectodermal contribution in the case of peripheral nerves.

Soft-tissue tumors constitute a large and heterogeneous group of neoplasms. Traditionally, tumors have been classified according to histogenetic features. (Fibrosarcoma, for example, is categorized as a tumor arising from fibroblasts.) However, histomorphologic, immunohistochemical, and experimental data suggest that most, if not all, sarcomas arise from primitive, multipotential mesenchymal cells, which in the course of neoplastic transformation differentiate along one or more lines.

Thus, a liposarcoma appears to arise from a lipoblast but may actually develop through lipoblastic differentiation of a precursor multipotent mesenchymal cell. At the clinical level, soft tissue tumors are classified according to various parameters, including location, growth pattern, likelihood of recurrence, presence and distribution of metastases, patient age, and prognosis.

Although most soft tissue tumors of various histogenetic types are classified as either benign or malignant, many are of an intermediate nature, which typically implies aggressive local behavior with a low-to-moderate propensity for metastasis.

Current achievements in the field of soft-tissue tumors are the result of advances in molecular biology, oncogenetics, imaging techniques, immunochemistry, diagnosis by fine-needle aspiration (FNA), surgical reconstruction, radiation therapy, and tissue banking.

Benign soft-tissue tumors are fairly common and are treated with surgery alone. Prior to the 1970s, surgery was the primary therapy for malignant soft tissue tumors, and most patients with high-grade tumors had a poor prognosis and a significant mortality. Since the mid-1970s, radiation therapy, chemotherapy, and advanced surgical techniques have helped increase long-term survival and decrease the need for ablative surgery. [1]

Future advances in molecular oncology may further improve diagnostic, prognostic, and treatment protocols for patients with soft-tissue sarcomas. [2, 3]  See Soft-Tissue Sarcomas: What You Need to Know, a Critical Images slideshow, to help identify and treat some of these malignant tumors of mesenchymal origin.


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