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Sarcomas in Children

Sarcomas are a type of cancer that grows in connective tissue, such as bones, muscles, tendons, fat, and other parts that support and connect your organs and other tissues.

There are many different types of sarcoma, and they can be classified into two main kinds: soft tissue sarcoma and bone sarcoma.

Types of Sarcoma in Children

The most common soft tissue sarcoma in children is rhabdomyosarcoma, a type of cancer that develops in immature muscle cells called rhabdomyoblasts. About half of all pediatric soft tissue sarcomas are rhabdomyosarcoma. Others include fibrosarcoma, mesenchymoma, synovial sarcoma, liposarcoma and more.

Most pediatric bone cancers are either osteosarcoma or Ewing’s sarcoma. Osteosarcoma, the most common bone cancer in children, usually forms in the long bones of the arms and legs. Ewing’s sarcoma usually forms in the pelvis, thigh, lower leg, upper arm or rib, though bone cancers can form in any bone in the body.

Sarcomas can occur at any age. Most rhabdomyosarcoma cases are diagnosed in children under 10. Other soft tissue sarcomas and bone sarcomas are most commonly diagnosed in adolescents and young adults.

Symptoms of Sarcomas in Children

Soft tissue sarcomas often cause a lump on the child’s body. Depending on the location, symptoms can include:

  • A lump or swelling that is firm and painless to touch
  • Abdominal pain
  • Hoarse voice, difficulty swallowing (for tumors on the neck)
  • Difficulty urinating (for bladder tumors)
  • Drooping eyelids, protruding eyeball, vision changes (for orbital tumors)

The most common symptom for bone sarcomas is bone pain. Other symptoms can include:

  • A lump on the bone
  • Stiffness, swelling or tenderness around a bone or joint
  • Limping (for tumors on a leg bone)
  • Broken bones
  • Fatigue, fever, weight loss, anemia

Because many of the symptoms of bone cancers are common in healthy adolescents and young adults, they are often mistaken for sports injuries or growing pains and can take a long time to diagnose.

Treatment for Sarcomas in Children

The goal of treatment for soft tissue sarcomas and bone sarcomas is usually to remove as much of the tumor as possible with surgery. Radiation and chemotherapy may also be used to shrink the tumor, or to kill any cancer cells that are left behind or that couldn’t be removed with surgery.

Rehabilitation is an important part of recovery from bone sarcoma surgery. Depending on the location of the tumor, some children with bone sarcomas may need to have bone grafts or implants to replace some of the bone that was removed, and sometimes they may need to have part of a limb amputated to get rid of all the cancer. Physical and occupational therapy can help sarcoma survivors learn to walk, move and resume a normal life again, sometimes with the help of braces, splints, walking aids or prosthetic devices.

Prognosis for Children with Sarcoma

The prognosis for children with sarcoma varies and depends on several factors:

  • The type of tumor
  • The child’s age at diagnosis
  • The size and location of the tumor
  • Whether the whole tumor can be removed surgically
  • How well the tumor responds to radiation and chemotherapy
  • Whether the cancer has spread to other parts of the body

Overall, about 60% of children with bone sarcoma and 50% of children with rhabdomyosarcoma survive. For other soft tissue sarcomas, survival rates are high if the tumor can be completely removed with surgery, and much lower if it has metastasized (spread beyond its original location).

Sometimes sarcomas come back after treatment. When that happens, the chances of survival are usually poor.

Colton’s Story

The first sign that something was wrong with Stephanie’s son Colton was the facial droop. Then came the ear pain and the dizziness. In a matter of weeks they would learn that what they thought was a bad ear infection was something much worse — parameningeal rhabdomyosarcoma.

Because of the tumor’s location in the middle of the ear, surgery wasn’t an option. Colton started on a long journey of 15 months of chemo and radiation and 30 rounds of proton therapy. “Chemotherapy made Colton very sick and he had neuropathy in his hands and feet, but he never let that steal his joy,” Stephanie said. 

Colton finished treatment on January 8 and is enjoying spending time at home with his family. He’s still dealing with the side effects of treatment, and he lives with the knowledge that his cancer could come back at any time. But Colton is staying positive, and he looks forward to starting kindergarten in the fall, playing baseball, and one day playing ice hockey like his big brother.

July is Sarcoma Awareness Month. Help children like Colton get the support they need to fight cancer, even after treatment is over. Donate to the American Childhood Cancer Organization today.

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