Difference Between Sarcoma and Cancer
Sarcoma is a specific type of cancer that originates from mesenchymal cells (connective tissue), while cancer is a broad term that includes all malignant neoplasms, including sarcomas, carcinomas, and other types. 1
Key Distinctions
Origin and Classification
- Cancer: General term for malignant neoplasms that can arise from any cell type in the body
- Sarcoma: Specifically refers to cancers arising from mesenchymal tissues including:
- Fat
- Muscle
- Nerves and nerve sheaths
- Blood vessels
- Bone
- Other connective tissues 1
Frequency
- Cancer: Encompasses all malignancies (including sarcomas)
- Sarcoma: Rare, accounting for approximately 1% of all adult malignancies and 15% of pediatric malignancies 1
Types and Subtypes
- Cancer: Includes carcinomas (epithelial origin), sarcomas (mesenchymal origin), leukemias, lymphomas, etc.
- Sarcoma: Over 50 different histologic subtypes divided into two main categories:
- Soft tissue sarcomas (STS): Including liposarcoma, leiomyosarcoma, synovial sarcoma, etc.
- Bone sarcomas: Including osteosarcoma, chondrosarcoma, Ewing's sarcoma, etc. 1
Diagnostic Approach
- Cancer: Diagnostic approach varies widely depending on the type
- Sarcoma: Requires specialized multidisciplinary teams with expertise in sarcoma management 1, 2
Specific Sarcoma Types
Soft Tissue Sarcomas
- Arise from fat, muscle, nerves, blood vessels, and other connective tissues
- Most common subtypes include pleomorphic sarcoma, liposarcoma, leiomyosarcoma, synovial sarcoma, and malignant peripheral nerve sheath tumors 1
- Most common primary sites: extremities (60%), trunk (19%), retroperitoneum (15%), and head and neck (9%) 1
Bone Sarcomas
- Named based on histologic origin:
- Chondrosarcomas arise from cartilage
- Osteosarcomas arise from bone
- Fibrosarcoma of bone originates from fibrogenic tissue
- Chordoma arises from notochordal tissue 1
- Ewing's sarcoma family of tumors (ESFT) has unknown histologic origin 1
Treatment Differences
General Cancer Treatment
- Treatment approaches vary widely based on cancer type, stage, and patient factors
Sarcoma Treatment
- Requires specialized multidisciplinary teams 2
- Soft tissue sarcomas: Wide surgical excision with negative margins, often combined with radiation therapy and/or chemotherapy 1
- Bone sarcomas: Multimodal approach with chemotherapy and surgery
- For osteosarcoma: MAP chemotherapy (methotrexate, doxorubicin, cisplatin) is standard first-line treatment for patients under 40 years 2
Clinical Pitfalls to Avoid
- Delayed Diagnosis: Sarcomas are often misdiagnosed initially due to their rarity and varied presentation
- Inappropriate Biopsy: Biopsy should be performed at specialized centers to avoid compromising subsequent definitive surgery 2
- Inadequate Margins: Surgical resection with inadequate margins increases risk of local recurrence 2
- Undertreatment: Particularly in older patients with sarcoma who can benefit from multimodal therapy up to at least age 60 2
Special Considerations
- Radiation-induced sarcomas can occur years after radiation therapy for other cancers 1
- Certain genetic syndromes like Li-Fraumeni syndrome increase risk of sarcomas 1
- Breast sarcomas should be distinguished from carcinosarcomas, which are primarily epithelial in nature 1
Understanding the distinction between sarcoma and cancer is essential for proper diagnosis, treatment planning, and patient education regarding these rare but important malignancies.