肉瘤

概述

肉瘤是指始于骨骼和软组织的一大类癌症。软组织用于连接、支撑和围绕其他身体结构。软组织包括肌肉、脂肪、血管、神经、肌腱和关节内膜。始于软组织的癌症称为软组织肉瘤。

肉瘤有很多种类型，可能出现在身体多个部位。肉瘤的治疗方法取决于肉瘤的类型、位置和其他因素。

Types

There are many types of sarcomas. Each type can behave differently and may require a different approach to diagnosis and treatment.

Some types of sarcomas don't fit neatly into one category. For example, Ewing sarcoma most often starts in bone but also can develop in soft tissue.

Some tumors start in soft tissues that connect and support, but they are not true sarcomas. Sarcoma specialists may treat these tumors, but they aren't always classified or treated in the same way as soft tissue sarcomas.

Bone sarcomas

• Osteosarcoma. Osteosarcoma starts in bone-forming cells. It most often develops in the long bones, particularly around the knee, and is most common in adolescents and young adults.
• Chondrosarcoma. Chondrosarcoma starts in cartilage-producing cells. It most often occurs in the pelvis, upper leg or shoulder and is more common in adults.
• Ewing sarcoma. Ewing sarcoma most often starts in bone but can start in soft tissue. It occurs most often in children, teenagers and young adults.

Soft tissue sarcomas

• Angiosarcoma. Angiosarcoma is a type of cancer that forms in the lining of the blood vessels and lymph vessels.
• Desmoplastic small round cell tumor (DSRCT). DSRCT is an aggressive sarcoma that usually starts in the abdomen or pelvis. It occurs most often in adolescents and young adults.
• Epithelioid sarcoma. Epithelioid sarcoma often starts in the hands, arms, feet or legs of teenagers and young adults. Other forms can start closer to the center of the body. Epithelioid sarcoma tends to grow slowly. It can come back after treatment.
• Kaposi sarcoma.This cancer can be caused by infection with the human herpes virus 8 (HHV-8) and is more likely to occur in people with weakened immune systems, including people with HIV. It also can happen in people who take medicines to prevent organ rejection after an organ transplant.
• Leiomyosarcoma. This cancer starts in smooth muscle tissue. Many areas of the body have smooth muscle tissue. Leiomyosarcoma most often starts in the uterus, belly or leg.
• Liposarcoma. Liposarcoma is a cancer that starts in the fat cells. It can happen anywhere in the body but occurs most often in the belly, arm or leg.
• Malignant peripheral nerve sheath tumor (MPNST). These tumors start in tissue that surrounds peripheral nerves. These nerves run from the spinal cord into the body. MPNST used to be called neurofibrosarcomas.
• Myxofibrosarcoma. This soft tissue sarcoma most often starts in the arms or legs of older adults. It can grow into surrounding tissues and often comes back in the same area after treatment.
• Rhabdomyosarcoma. This sarcoma starts in muscle tissue. It occurs most often in children and adolescents, although adults can develop it.
• Synovial sarcoma. This cancer tends to happen near large joints, mainly the knees. It usually affects young adults.
• Undifferentiated pleomorphic sarcoma (UPS). The name comes from the way the cancer cells appear under the microscope. Undifferentiated means the cells don't look like the body tissues in which they develop. The cancer is called pleomorphic (plee-o-MOR-fik) because the cells grow in multiple shapes and sizes.

Other related tumors

• Dermatofibrosarcoma protuberans (DFSP). DFSP is a type of skin cancer that starts in the connective tissue cells in the middle layer of the skin. It typically grows slowly but can grow into nearby tissues.
• Gastrointestinal stromal tumor (GIST). GIST is a type of cancer that begins in the digestive system. These tumors happen most often in the stomach and small intestine.
• Solitary fibrous tumor. These tumors start in the connective tissue and can develop almost anywhere in the body. They often occur in the lining around the outside of the lungs. They tend to grow slowly.

症状

肉瘤的体征和症状包括：

• 可以通过皮肤感觉到的肿块，有可能有痛感或无痛感。
• 骨痛。
• 没有明确原因的骨折（例如只是轻微受伤或完全没有受伤）。
• 腹部疼痛。
• 体重下降。

何时就医

如果出现任何令您担忧的症状，请与医生或其他医疗护理专业人员约诊。

病因

尚不清楚导致肉瘤的病因。这种癌症最开始是骨骼和软组织中的一个细胞生长物。

肉瘤出现在细胞中的 DNA 发生变化时。细胞的 DNA 含有指示细胞进行哪些活动的指令。在正常细胞中，DNA 指示细胞按设定速度生长和增殖。DNA 还会指示细胞在设定时间死亡。

在癌细胞中，发生变化的 DNA 会给出其他指令。这些变化指示癌细胞迅速生长和增殖。在正常细胞应该死亡时，癌细胞仍继续存活。这会导致细胞过多。

这些癌细胞可能会形成一个肿块，称为肿瘤。肿瘤可能生长、侵入并破坏正常的机体组织。随着时间的推移，癌细胞可能脱离并扩散至身体其他部位。扩散的癌症被称为转移癌。

风险因素

可能会增加患肉瘤风险的因素包括：

• 遗传性综合征。 某些会增加罹患癌症风险的综合征可能会从父母传给子女。例如，可增加罹患肉瘤风险的综合征包括利-弗劳梅尼综合征、家族性视网膜母细胞瘤和 1 型神经纤维瘤病。
• 癌症的放射疗法。 癌症放射治疗会增加日后罹患肉瘤的风险。
• 淋巴水肿。 淋巴水肿是指当淋巴系统被阻塞或损伤时发生的肿胀。淋巴水肿会增加罹患血管肉瘤的风险。
• 接触病毒。 人类疱疹病毒 8 型可能会增加免疫系统功能低下患者罹患卡波西肉瘤的风险。

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