 Anatomical location of tumor :

 extremity (59%)
 trunk (19%)
 retroperitoneal (13%)
 head and neck (9%)
 rare in GI tract, accept of :
 Stomach
 Small bowel
 Rectum
 Esophagus
 Clinical sign and symptom of Soft Tissue
Tumor depend on :
 Anatomical location
 Size
 Histopathological feature
 Histopathological grading
BENIGN TYPE SOFT TISSUE TUMOR

 FIBROMA
 Fibrous tissue
 Solid
 Consist of normal cells
 Obvious/define border
 Capsulated

 Treatment : Extirpation
 LIPOMA
 Fat tissue
 Solid soft tumor
 Lobulated
 Define border
 Location : >> fat tissue
 Treatment : Extirpation
 Haemangioma / Lymphangioma
 Blood / Lymph vessel ( endothelium tissue )
 Soft tumor
 Compressible
 Absurd border

 Treatment : Excision
MALIGNANT SOFT TISSUE TUMOR

 Synonym : SARCOMA
 Name depend on origin tissue
 Sign and symptom depend on :
 Anatomical location
 Size
 Adjacent tissues infiltration and far metastasis
 HISTOPATHOLOGICAL CLASSIFICATION
No TISSUE ORIGIN MALIGNANT TYPES

1 Fibrous Fibrosarcoma
2 Fibrohistiocytic Malignant fibrous histiocytoma
3 Lipomatous Liposarcoma
4 Smooth muscle Leiomyosarcoma
5 Skeletal muscle Rhabdomyosarcoma

6 Blood vessel Angiosarcoma

7 Lymph vessel Lymphangiosarcoma
8 Perivascular Malignant hemangio pericytoma
9 Synovial Synovial sarcoma
10 Paraganglionic Malignant paraganglioma
11 Mesothelial Malignant schwannoma
12 Extra skeletal cartilaginous Extraskeletal chondrosarcoma
and osseous Extraskeletal osteosarcoma
13 Pluripotential mesenchymal Malignant mesenchymoma

14 Neural - Neuroblastoma
- Extraskeletal Ewing’s sarcoma
15 Miscellaneous - Alveolar soft part sarcoma
- Epithelioid sarcoma
- Malignant extra renal rhabdoid tumor
- Desmoplastic small cell tumor
 Diagnosis :
 Anamesis :
 Rapid growth tumor
 Risk factor
 Physical examination
 Imaging procedure :
 MRI
 CT Scan
 CXR
 CLINICAL STATE
UICC and AJCC 2002
 T – Primary tumor
 T0 No evidence of primary tumor
 T1 Tumor < 5 cm in greatest dimention
T1a Superficial tumor
T1b Deep tumor
 T2 Tumor > 5cm in greatest dimention
T2a Superficial tumor
T2b Deep tumor
 N – Regional lymph nodes
 N0 No regional lymph node metastasis
 N1 Regional Lymph node metastasis
 M – Distant metastasis
 Mo No distant metastasis
 M1 Distant metastasis
 G – Histopathologic grade
 Low grade
 High grade
 STADIUM

 Stage I A Low grage T1a N0 M0

Low grade T1b N0 M0
 Stage I B Low grade T2a N0 M0
Low grade T2b N0 M0
 Stage II A High grade T1a N0 M0
High grade T1b N0 M0
 Stage II B High grade T2a N0 M0
 Stage III High grade T2b N0 M0
 Stage IV Any grade Any T N1 M0
Any grade Any T Any N M1
 Modality of treatment :
 Surgery : main treatment
 Wide radical excision
 Compartment excision
 Amputation / exarticulation
 Lymph node dissection
 Radiation :
 Adjuvant
 Chemotherapy :
 Primer
 Adjuvant