Childhood soft tissue sarcoma – How is it diagnosed?
Soft tissue sarcomas are malignant tumours that begin in soft tissue, such as muscle, fibrous tissues, tendons, fat, nerves, joint tissues, and blood vessels. They are rare and can form anywhere in the body.
Symptoms can include either a painless or painful swelling or a lump. These symptoms can be difficult to identify in children, so prompt evaluation of any lump or mass is important.
Diagnostic tests
Diagnosing a soft tissue sarcoma begins with a complete medical history and physical examination. A detailed neurological assessment may also be performed.
Doctors use a variety of diagnostic tests to correctly diagnose soft tissue tumours. These include an MRI scan which uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs, soft tissues, muscles, ligaments, and other structures within the body. Your child isn’t exposed to radiation during an MRI. MRIs usually require the children to lie very still and as such, they often require a general anaesthetic during the procedure. The MRI machine looks like a small tunnel; the exam table moves through the opening of the tunnel and the machine does make a lot of noise during the scan.
An ultrasound or sonar which uses sound waves to produce images of the organs and soft tissues inside the body may also be done. The images are viewed live and continually on a computer screen and can help detect any abnormalities.
X-rays which produce images of bones and joints are also used. PET scan which uses radioactive sugar injected into a vein and a scanner to make detailed, computerised pictures of areas of the body is also used.
A biopsy of the tumour or lump makes the diagnosis. A doctor, usually a radiologist, places a small needle through the skin and into the lesion to withdraw a small sample of the abnormal tissue, often using ultrasound or a CT scan to guide them. The tissue is analysed to confirm any findings. Sometimes an operation is required to make the diagnosis. This depends on the location of the tumour. Both the biopsy and operation would usually require an anaesthetic.
Childhood cancer is rare and comprises less than 1% of all malignant disease. It occurs in about 1 in 650 children, or 140 children per million. It’s estimated that almost half the children with cancer in SA will never be diagnosed.
The most common types are as follows:
- Leukaemia 34%
- Brain tumours 22%
- Lymphoma 11%
- Nephroblastoma 6%
- Neuroblastoma 6%
- Soft tissue sarcoma 6%
- Bone tumours 5%
Dr Kate Bennett is a paediatric oncologist; she qualified as a paediatrician in 2009 and then as a paediatric oncologist in 2011. She has a special interest in the treatment of paediatric leukaemia and lymphoma, immune thrombocytopaenia, and sickle cell anaemia.
Header image by Freepik
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