Soft Tissue Sarcomas

Soft tissue sarcomas are rare, comprising only one percent of all cancer cases. For that reason, it can be difficult to diagnose and treat unless you have a physician with a soft tissue tumors specialization. Dr. Daniel C. Allison team at Cedars-Sinai Medical Center in Los Angeles are exceptionally qualified and experienced in the diagnosis and treatment of this complex disease and provide a coordinated, multi-disciplinary approach which soft tissue tumors treatment requires.

According to the National Cancer Institute, there are approximately 11,280 new cases of soft tissue tumors in the United States each year. Slightly more men than women develop soft tissue sarcoma and the distribution among ethnicities mirrors that of the U.S. population. Studies have shown that previous radiation exposure could be a risk factor for this disease. Due to its rarity, it is crucial for patients to seek a cancer specialist such as Dr. Allison in Los Angeles in the treatment of soft tissue tumors.

The sarcoma develops in soft connective and structural tissues of the body such as muscle, fat, blood vessels, nerves, tendons and the lining of your joints. There are many types of soft tissue tumors and each can develop throughout the body including extremities (60%), trunk (20%), inner abdomen (15%), and head and neck (5%). Slightly more men than women develop this disease with certain types more common in children and others in adults.

Dr. Allison is one of the few orthopedic oncologists in the nation with the specialized knowledge and expertise in early detection and treatment of malignant sarcoma. This cancer requires a multi-disciplinary treatment by a team with extensive resources such as Dr. Allison’s practice at Cedars-Sinai Medical Center. If you or a loved one has been diagnosed with soft tissue sarcoma or are experiencing symptoms that may indicate the presence of the disease, get in contact with Dr. Allison in Beverly Hills today by filling out the online contact form or calling (310) 730-8008.

What Can You Expect During Sarcoma Treatment?

Dr. Allison collaborates with you to review all of your treatment options so together as physician and patient, you elect a treatment that best suits your needs and goals.

Depending upon a patient’s sarcoma type and grade, Dr. Allison might pair surgery with additional treatments such as radiation therapy and possibly chemotherapy as follows:

    • Low-grade tumors with minimal tumor activity have a low potential rate of metastasis (<10%) and are treated usually with surgery alone, but sometimes radiation can be added.
    • Intermediate grade tumors have mild tumor growth and metastatic risk (10-30%) and are usually treated with a combination of surgery and radiation.
    • High-grade tumors grow rapidly and have a higher risk of spread (>30%) and are treated with surgery and radiation therapy, with or without additional chemotherapy. Radiation can be performed before or after surgical resection. Adjuvant chemotherapy is controversial and depends on the size of the tumor, the medical status of the patient, and the subtype of the tumor.

Patients in Los Angeles are followed for at least five years from the time of surgical resection, looking for appropriate healing, optimization of function, local recurrence of the tumor or systemic spread. These outcomes are measured through periodic history and physical exams, MRI’s of the area, and CT scans of the chest.

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There are approximately 50 different types of soft tissue sarcomas with subtype determined by the location and type of connective tissue where they develop.

The more common varieties include:

    • Pleomorphic Sarcoma (formerly malignant fibrous histiocytoma [MFH]) (most common [25%])
    • Liposarcoma (2nd most common [15%])
    • Leiomyosarcoma (3rd most common [10%])
    • Synovial sarcoma (4th most common [7%])
    • Malignant peripheral nerve sheath tumor (MPNST [neurofibrosarcoma])
    • Rhabdomyosarcoma
    • Hemangiopericytoma
    • Fibrosarcoma
    • Hemangioendothelioma
    • Angiosarcoma
    • Alveolar soft part sarcoma
    • Epithelioid sarcoma

The complex nature of sarcomas treatment requires a sophisticated medical team. Treatment requires a coordinated, multi-disciplinary team approach at a high-level center with extensive resources and medical professionals experienced in and dedicated to the treatment of these relatively rare, but important cancers.

What are the Symptoms of Soft Tissue Sarcomas

Soft tissue sarcoma at an early stage rarely causes any symptoms, and tumors can grow quite large before they are felt. The first symptom is usually a painless lump. As soft tissue tumors grow and begin to press against nearby nerves and muscles, pain or soreness can occur.


Patients with soft tissue sarcoma usually present with an enlarged painless mass. Physical exam reveals a firm adherent, often deep, connective tissue growth. Imaging studies aid in the diagnosis usually performed with X-rays as they can identify calcification in the mass and bone involvement. An MRI is helpful in the diagnosis by revealing the location, size, and appearance of the mass, and it is also effective in guiding the biopsy and eventual resection. Definitive diagnosis, however, requires tissue sampling (biopsy).


The complex nature of sarcoma treatment demands a team of specialists who thoroughly examine your condition in order to develop the best treatment plan for you. Dr. Allison includes tumor staging as an essential step in evaluating the extent of your sarcoma. He looks at tumor grade (degree of cellular activity and aggressiveness), anatomic extent (size and depth), and presence of tumor spread (to local lymph nodes or the lungs). This requires biopsy, an MRI of the area, and a CT scan of the chest.

For some soft tissue tumors, Dr. Allison in Los Angeles might include additional studies such as a CT of the abdomen and pelvis (myxoid liposarcoma), lymph node biopsy (epitheliod sarcoma, rhabdomyosarcoma, clear cell sarcoma), and bone marrow biopsy (rhabdomyosarcoma). PET/CT scanning is another diagnostic which is emerging as a test to assess all three aspects of staging (grade, size, and metastasis), but it is not a perfect study and not yet the standard of care.