MR-HIFU

Safety and Feasibility of MR-HIFU Ablation of Relapsed or Refractory Pediatric Solid Tumors

Magnetic resonance guided high intensity focused ultrasound (MR-HIFU) is an ultrasound-based technology that can raise temperature under the guidance of MR. MR-HIFU delivers safe, precise and controlled heating by focusing ultrasound energy inside a lesion, without the need for a scalpel or needle. Advantages over conventional local tumor control methods such as surgery or radiation are that MR-HIFU is non-invasive and non-ionizing.

solid tumor MR-HIFUHIFU has been used for variety of solid tumor treatment in adults, including ablative therapy for uterine fibroids, breast, pancreas, and soft-tissue sarcomas, and for relief of pain from bone metastases. Clinical trials in adults thus far have demonstrated HIFU to be safe and well tolerated with minimal solid tumor treatment complications.

At Children’s National, we currently have the first solid tumor clinical trial open for enrollment evaluating the safety and feasibility of MR-HIFU for the ablation of refractory or relapsed solid tumors in children (ClinicalTrials.gov Identifier NCT02076906). Children ≤ 21 years of age with histologically confirmed relapsed or refractory solid tumor may be eligible to enroll. Tumor target lesions will be limited to those that are located in bone or soft tissue in close proximity to bone.

Background of Solid Tumor and MR-HIFU

  • Prognosis for children diagnosed with metastatic sarcoma or recurrent solid tumors continues to remain unacceptably poor.
  • A critical need exists for improvement in therapeutic approaches to minimize side effects while maximizing the efficacy of treatment.
  • We propose the first magnetic resonance-guided high intensity focused ultrasound (MR-HIFU) mediated refractory solid tumor trial for pediatric patient with the long-term objective of overcoming clinical challenges, improving quality of life and cure rates.
  • MR-HIFU delivers safe, precise and controlled heating by focusing ultrasound energy inside a lesion
  • No need for a scalpel or a needle

Solid Tumor Trial Study Goals

  • To evaluate safety and feasibility of MR-HIFU ablation for refractory or relapsed solid tumors in children

Solid Tumor Trial Eligibility

  • Children and young adults 30 years of age and younger, with histologically confirmed relapsed or refractory solid tumor including but are not limited to rhabdomyosarcoma and other soft tissue sarcomas, Ewing’s sarcoma family of tumors, osteosarcoma, neuroblastoma, Wilms’ tumor, hepatic tumors, germ cell tumors.
  • Target tumor lesions will be limited to those that are located in bone or in close proximity to bone.

Solid Tumor Treatment Features and Benefits

  • Non-invasive MR-HIFU ablation
  • No ionizing radiation
  • Precise MRI-based therapy planning and execution
  • Real-time temperature imaging
  • Possible disease stabilization, shrinkage, or alleviation of symptoms.

For more information about solid tumor trial, please contact

 

 

 

 

More Background

Ewing Sarcoma

What is Ewing sarcoma?

Ewing sarcoma is a cancer that occurs primarily in the bone or soft tissue. Ewing sarcoma can occur in any bone, but is most often found in the extremities and can involve muscle and the soft tissues around the tumor site. Ewing sarcoma cells can also spread (metastasize) to other areas of the body including the bone marrow, lungs, kidneys, heart, adrenal gland, and other soft tissues. Ewing sarcoma accounts for about 1.8 percent of childhood cancers. About 150 children and adolescents are diagnosed with Ewing sarcoma each year in the US. It is the second most common malignant bone tumor in children and adolescents. Ewing sarcoma most often occurs in children between the ages of 5 and 20. The number of males affected is slightly higher than the number of females.

What causes Ewing sarcoma?

The majority of Ewing sarcomas result from a chromosome rearrangement between chromosomes #11 and #22. This rearrangement changes the position and function of genes, causing a fusion of genes referred to as a fusion transcript. Over 90 percent of individuals have an abnormal fusion transcript, involving two genes known as EWS and FLI1. This important discovery has led to improvements in diagnosing Ewing sarcoma. Similar to osteogenic sarcoma, trauma or injury is sometimes involved with the site at the time of diagnosis. However, this trauma is thought to bring the condition to attention rather than to have any causal relationship. Some physicians classify Ewing sarcoma as a primitive neuroectodermal tumor (PNET). This means the tumor may have started in fetal, or embryonic, tissue that has developed into nerve tissue.

What are the symptoms of Ewing sarcoma?

The following are the most common symptoms of Ewing sarcoma. However, each child may experience symptoms differently. Symptoms may include, but are not limited, to the following:

  • Pain around the site of the tumor
  • Swelling and/or redness around the site of the tumor
  • Fever
  • Weight loss, decreased appetite
  • Fatigue
  • Paralysis and/or incontinence if the tumor is in the spinal region
  • Numbness, tingling, paralysis, and other symptoms related to nerve compression from the tumor

The symptoms of Ewing sarcoma may resemble other conditions or medical problems. Always consult your child’s physician for a diagnosis.

How is Ewing sarcoma diagnosed?

In addition to a complete medical history and physical examination of your child, diagnostic procedures for Ewing sarcoma may include:

  • X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. This test is used to measure and evaluate the curve.
  • Bone scans are a nuclear imaging method that evaluates any degenerative and/or arthritic changes in the joints. Bone scans detect bone diseases and tumors, determine the cause of bone pain or inflammation and rule out any infection or fractures.
  • Magnetic resonance imaging (MRI) – is a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.
  • Computer-assisted tomography scan (CT or CAT scan) is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  • Blood tests, including blood chemistries.
  • Biopsy of the tumor, which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Bone marrow aspiration and/or biopsy. This procedure involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

Ewing sarcoma is difficult to distinguish from other similar tumors. Diagnosis is often made by excluding all other common solid tumors, and by the use of genetic studies.

Osteogenic Sarcoma

What is osteogenic sarcoma?

Also called osteosarcoma, osteogenic sarcoma is one of the most common types of bone cancer in children and accounts for nearly 3 percent of all childhood cancers. About 400 children are diagnosed with osteosarcoma each year. The disease usually occurs in the long bones, such as the arms (humerus), legs (femur/tibia), and pelvis. It rarely occurs in the jaw and fingers, but often occurs at the ends of these bones near growth plates. Osteosarcoma affects children most often between 10 and 25 years of age. This cancer is also more prevalent in males than in females, possibly because of the rapid growth rate at this age. Prior to adolescence, the percentage of affected males and females is equal. Osteogenic sarcoma cancer cells can also spread (metastasize) to other areas of the body. Most commonly, these cells spread to the lungs. However, bones, kidneys, the adrenal gland, the brain, and the heart can also be sites of metastasis.

What causes osteogenic sarcoma?

Repeated trauma

It has been suggested that repeated trauma to an area may be a risk factor for developing this type of cancer. It is uncertain whether trauma is a cause or effect of the disease. Cancer lesions in the bone can make that area of the bone weaker, thus, making injury more likely. However, repeated injuries to a certain area of the bone may lead to an increased production of osteoid tissue to repair the damaged area. The rapid production of osteoid tissue may lead to the malignancy. It is thought, most often, that injury simply brings the condition to attention and has no causal relationship.

Genetics

Genetics may play an important role in developing osteosarcoma. Children and adults with other hereditary abnormalities, including exostoses (bony growths), retinoblastoma, Ollier’s disease, osteogenesis imperfecta, polyostotic fibrous dysplasia, and Paget’s disease, have an increased risk for developing osteosarcoma.

Exposure to ionizing irradiation

This form of cancer has also been linked to exposure to ionizing irradiation associated with radiation therapy for other types of cancer (i.e., Hodgkin and non-Hodgkin disease).

What are the symptoms of osteogenic sarcoma?

The following are the most common symptoms of osteogenic sarcoma. However, each child may experience symptoms differently. Symptoms may include, but are not limited to, the following:

  • Pain (sharp or dull) at the site of the tumor
  • Swelling and/or redness at the site of the tumor
  • Increased pain with activity or lifting
  • Limping
  • Decreased movement of the affected limb

The symptoms may have been present over a short period of time or may have been occurring for six months or more. Often, an injury brings a child into a medical facility where an x-ray may indicate suspicious bone lesions. The symptoms of osteogenic sarcoma may resemble other conditions or medical problems. Always consult your child’s physician for a diagnosis.

How is osteogenic sarcoma diagnosed?

In addition to a complete medical history and physical examination of your child, diagnostic procedures for osteogenic sarcoma may include:

  • X-rays use invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. This test is used to measure and evaluate the curve.
  • Bone scans are a nuclear imaging method that evaluates any degenerative and/or arthritic changes in the joints. Bone scans detect bone diseases and tumors, determine the cause of bone pain or inflammation and rule out any infection or fractures.
  • Magnetic resonance imaging (MRI) – is a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.
  • Computer-assisted tomography scan (CT or CAT scan) is a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
  • Complete blood count (CBC) is a measurement of size, number and maturity of different blood cells in a specific volume of blood.
  • Blood tests, including blood chemistries.
  • Biopsy of the tumor, which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
  • Bone marrow aspiration and/or biopsy. This procedure involves taking a small amount of bone marrow fluid (aspiration) and/or solid bone marrow tissue (called a core biopsy), usually from the hip bones, to be examined for the number, size, and maturity of blood cells and/or abnormal cells.

Treatment

The specialists at Children’s National Health System aim not only to cure the cancer, but also to minimize the side effects of treatment. Specific treatment for a bone tumor will be determined by a child’s physician based on the:

  • Child’s age, overall health, and medical history
  • Type, location, and size of the tumor
  • Extent of the disease

Treatment may include one, or more, of the following:

  • Surgery
  • Cyberknife therapy
  • Radiation therapy
  • Amputation
  • Resections for metastases, such as pulmonary resections of cancer cells in the lung
  • Rehabilitation including physical and occupational therapy, and psychosocial adaptation
  • Prosthesis fitting and training
  • Antibiotics to prevent and treat infections
  • Continual follow-up care to determine response to treatment, detect recurrent disease, and manage late effects of treatment

Long-term outlook for a child with Ewing sarcoma or osteosarcoma

The factors for determining the prognosis and long-term survival of children with Ewing sarcoma or osteosarcoma include the following: Prognosis greatly depends on the:

  • Child’s age
  • Extent of the disease (presence or absence of metastasis)
  • Other factors that may play role in the outcome include:
    • Size and location of the tumor
    • Tumor’s response to therapy
    • Child’s tolerance of specific medications, procedures, or therapies

As with any cancer, prognosis and long-term survival can vary greatly from child to child. Every child is unique and treatment and prognosis is structured around the child’s needs. Prompt medical attention and aggressive therapy are important for the best prognosis. Continuous follow-up care is essential. Late effects of radiation and chemotherapy, as well as second malignancies, can occur in survivors of Ewing sarcoma and osteosarcoma. New methods are continually being discovered to improve treatment and to decrease side effects.

 

Germ Cell Tumors

What are germ cell tumors?

Germ cell tumors are malignant (cancerous) or nonmalignant (benign, noncancerous) tumors that are comprised mostly of germ cells. Germ cells are the cells that develop in the embryo (fetus, or unborn baby) and become the cells that make up the reproductive system in males and females. These germ cells follow a midline path through the body after development and descend into the pelvis as ovarian cells or into the scrotal sac as testicular cells. Most ovarian tumors and testicular tumors are of germ cell origin. The ovaries and testes are called gonads.

Tumor sites outside the gonad are called extragonadal sites. The tumors also occur along the midline path and can be found in the head, chest, abdomen, pelvis, and sacrococcygeal (lower back) area.

Germ cell tumors are rare. Germ cell tumors account for about 2 to 4 percent of all cancers in children and adolescents younger than age 20.

Germ cell tumors can spread (metastasize) to other parts of the body. The most common sites for metastasis are the lungs, liver, lymph nodes, and central nervous system. Rarely, germ cell tumors can spread to the bone, bone marrow, and other organs.

Prevention & Risk Assessment

What causes germ cell tumors?

The cause of germ cell tumors isn’t completely understood. A number of inherited defects have also been associated with an increased risk for developing germ cell tumors including the central nervous system and genitourinary tract malformations and major malformations of the lower spine. Specifically, males with cryptorchidism (failure of the testes to descend into the scrotal sac) have an increased risk to develop testicular germ cell tumors. Cryptorchidism can occur alone, however, and is also present in some genetic syndromes.

Some genetic syndromes caused by extra or missing sex chromosomes can cause incomplete or abnormal development of the reproductive system.

What are the symptoms of germ cell tumors?

The following are the most common symptoms of germ cell tumors. However, each child may experience symptoms differently. Symptoms vary depending on the size and location of the tumor. Symptoms may include:

  • A tumor, swelling, or mass that can be felt or seen
  • Elevated levels of alpha-fetoprotein (AFP)
  • Elevated levels of beta-human chorionic gonadotropin (ß-HCG)
  • Constipation, incontinence, and leg weakness can occur if the tumor is in the sacrum (a segment of the vertebral column that forms the top part of the pelvis) compressing structures
  • Abdominal pain
  • Abnormal shape, or irregularity in, testicular size
  • Shortness of breath or wheezing if tumors in the chest are pressing on the lungs

The symptoms of germ cell tumors may resemble other conditions or medical problems. Always consult your child’s doctor for a diagnosis.

 

Neuroblastoma

What is neuroblastoma?

Neuroblastoma is a cancerous tumor that begins in nerve tissue of infants and very young children. The abnormal cells are often found in the nerve tissue that is present in the unborn baby and later develops into a detectable tumor. Neuroblastoma is rare in children older than 10 years of age, however, it does occur occasionally in adults.

The tumor usually begins in the tissues of the adrenal gland found in the abdomen, but may also begin in nerve tissue in the neck, chest, or spinal cord. The adrenal glands are positioned on top of the kidneys. These glands secrete hormones and other important substances that are required for normal functions in the body.

In the U.S., approximately 700 children are diagnosed with neuroblastoma each year. It is often present at birth, but not detected until the tumor begins to grow and compress the surrounding organs. Most children affected by neuroblastoma have been diagnosed before the age of 5. In rare cases, neuroblastoma can be detected before birth by a fetal ultrasound. It is the most common solid tumor cancer in infants.

Neuroblastoma cancer cells can spread (metastasize) quickly to other areas of the body (for example, lymph nodes, liver, lungs, bones, central nervous system, and bone marrow). Approximately two-thirds of all children diagnosed with neuroblastoma will have some metastatic disease.

Prevention & Risk Assessment

What causes neuroblastoma?

The only risk factor that has been established for neuroblastoma is heredity, although the vast majority of neuroblastomas are not inherited. Recent research indicates that certain genetic variations double the risk of this disease. Also, having this particular variation increases the chance that a child will develop a more aggressive form of the disease.

The average age at diagnosis in genetically linked cases is younger than those cases that are not inherited. Cancer that presents in several different areas of the body at once is a sign that it may be a genetically inherited cancer.

What are the symptoms of neuroblastoma?

The following are the most common symptoms of neuroblastoma. However, each child may experience symptoms differently. The symptoms of neuroblastoma vary greatly depending on size, location, and spread of the tumor. Symptoms may include:

  • Abdominal mass either felt during an examination or seen as swollen abdomen
  • Painless, bluish lumps may be seen under the skin in infants
  • Trouble breathing due to tumors in the chest or abdomen
  • Tumors in the face or head can cause swelling and bruising of the area around the eyes and uncontrolled eye movement or bulging eyes
  • Compression of kidney or bladder by the tumor may cause changes in urination
  • Bone marrow involvement may present as pain, fatigue, limping, paralysis, or weakness
  • Diarrhea may be present; diarrhea is caused by a substance produced by the tumor (vasoactive intestinal peptide or VIP)
  • Fever
  • High blood pressure and increased heart rate may occur depending on location of tumor and the organs the tumor compresses

The symptoms of neuroblastoma may resemble other conditions or medical problems. Always consult your child’s doctor for a diagnosis.

 

Wilms Tumor

What is Wilms tumor?

Wilms tumor, also called nephroblastoma, is a malignant (cancerous) tumor originating in the cells of the kidney. It is the most common type of renal (kidney) cancer in children and accounts for about 5 percent of all childhood cancers.

Approximately 500 children in the U.S. are diagnosed with Wilms tumor each year.

The disease can occur at any age between infancy and 15 years, but in most cases, the tumor is detected by the age of 3. It is slightly more common among girls and African-Americans.

The tumor can be very large and it may spread (metastasize) to other body tissues. The most common site for Wilms tumor to metastasize is the lungs. Lesions may also occur, however, in the liver, the other kidney, brain, and/or bones. In approximately 5 percent of children with Wilms tumor, both kidneys are involved.

Prevention & Risk Assessment

What causes Wilms tumor?

It is uncommon for Wilms tumor to run in families. Only 1 to 2 percent of cases will have an affected relative. Most cases of Wilms tumor are considered sporadic (occur by chance) and are the result of genetic mutations that affect cell growth in the kidney. These mutations generally arise after birth, but, in some cases, children are born with a genetic alteration that predisposes them to cancer.

A small percentage of patients with Wilms tumor have one of three genetic syndromes, including the following:

  • WAGR syndrome. The acronym WAGR stands for the four diseases present in WAGR syndrome: Wilms tumor, aniridia (absence of the iris, the colored part of the eye), genitourinary malformations (defect of the kidneys, urinary tract, penis, scrotum, clitoris, testicles, or ovaries), and intellectual disability. This is caused by loss or inactivation of a tumor suppressor gene called WT1 on chromosome 11. Tumor suppressor genes usually suppress the growth of tumors and control cell growth. When altered, they no longer control cell growth, and tumors may form.
  • Denys-Drash syndrome. This syndrome is characterized by kidney failure when the child is very young, genitourinary malformations, and abnormal development of the reproductive organs. This is also caused by an abnormality on chromosome 11.
  • Beckwith-Wiedemann syndrome. This syndrome is characterized by large birthweight and a large liver, spleen, and tongue; low blood sugar in neonatal period, malformations around the ear, asymmetric growth of the body, abdominal wall defects near the navel (omphalocele), and tumors of the liver and adrenal glands. This is thought to be caused by an overactive copy of an oncogene on chromosome 11, called IGF2. Oncogenes control cell growth, but, if mutated, uncontrolled cell growth may result.

What are the symptoms of Wilms tumor?

The following are the most common symptoms of Wilms tumor. However, each child may experience symptoms differently. Symptoms may include:

  • A nontender mass, or lump, felt or seen in the abdomen
  • Swelling of the abdomen
  • Blood in the urine (hematuria)
  • Pain in the abdomen from pressure on other organs near the tumor
  • Decreased appetite and weakness or tiredness
  • Constipation
  • Fever
  • High blood pressure (hypertension)

If a tumor is suspected in the child’s abdomen, it is important not to apply pressure to this area. Careful bathing and handling of the child is necessary before and during any tumor evaluation. Rupture of the tumor may lead to cancer cells spreading to other tissues in the body.

These symptoms of Wilms tumor may resemble other medical conditions or serious illnesses. Always consult your child’s doctor for a diagnosis.

 

Rhabdomyosarcoma

What is rhabdomyosarcoma?

Rhabdomyosarcoma is a cancerous tumor that originates in the soft tissues of the body, including the muscles, tendons, and connective tissues. The most common sites for this tumor to be found include the head, neck, bladder, vagina, arms, legs, and trunk. Rhabdomyosarcoma can also be found in places where skeletal muscles are absent or very small, such as in the prostate, middle ear, and bile duct system. The cancer cells associated with this disease can spread (metastasize) to other areas of the body.

Embryonal rhabdomyosarcoma, the most common type, usually occurs in children under 6 years of age. Alveolar rhabdomyosarcoma occurs in older children and is less common.

Rhabdomyosarcoma accounts for about 3 percent of childhood cancers. In the U.S., about 350 children are diagnosed with rhabdomyosarcoma each year. This disease mostly affects children under the age of 10, but can occur at any age. For unknown reasons, males are affected slightly more often than females.

Prevention & Risk Assessment

What causes rhabdomyosarcoma?

It is believed that some rhabdomyosarcoma tumors begin developing in the fetus. Rhabdomyoblasts are the cells at the initial stages of development of an unborn baby. These cells will mature and develop into muscles. There has been much research into the gene structure of these rhabdomyoblasts and possible detection of a gene error that can produce the disease later in development.

Rhabdomyosarcomas usually have some type of chromosome abnormality in the cells of the tumor, which are responsible for the tumor formation. In children with an embryonal rhabdomyosarcoma, there is usually an abnormality of chromosome 11. In alveolar rhabdomyosarcoma, a rearrangement in the chromosome material between chromosomes 2 and 13 is usually present. This rearrangement changes the position and function of genes, causing a fusion of genes referred to as a fusion transcript. Patients have an abnormal fusion transcript involving two genes known as PAX3 and FKHR. This important discovery has led to improvements in diagnosing rhabdomyosarcoma.

Rhabdomyosarcomas are also more common in children with neurofibromatosis or Li-Fraumeni syndrome, which are genetic disorders. Li-Fraumeni syndrome is a clustering of soft tissue and other cancers in a family caused by mutations in a tumor suppressor gene called p53, which results in uncontrolled cell growth.

There has been no association between rhabdomyosarcoma and environmental exposures.

What are the symptoms of rhabdomyosarcoma?

The following are the most common symptoms of rhabdomyosarcoma. However, each child may experience symptoms differently. Many symptoms depend on the size and the location of the tumor. Symptoms may not be present until the tumor is very large, especially if it is located deep in the muscle or in the stomach. Symptoms may include:

  • A tumor or mass that can be seen or felt (may or may not be painful)
  • Bleeding from the nose, vagina, rectum, or throat (may occur if the location of the tumor is in these areas)
  • Tingling, numbness, pain, and movement may be affected if the tumor compresses nerves in the area
  • Protrusion of the eye or a drooping eyelid (may indicate a tumor behind the eye)

The symptoms of rhabdomyosarcoma may resemble other conditions or medical problems. Always consult your child’s doctor for a diagnosis.

 

Soft Tissue Sarcoma

What is soft tissue sarcoma?

Soft tissue sarcoma is a type of cancer that grows in soft tissues that support and connect parts of the body, including:

What causes soft tissue sarcoma?

Medical experts do not know exactly what causes soft tissue sarcomas. Some factors that may increase your child’s risk include:

  • Inherited genetic disorders such as neurofibromatosis and Li-Fraumeni syndrome
  • Prenatal genetic changes caused by certain chromosome abnormalities
  • Previous radiation therapy treatment
  • Exposure to certain chemicals, such as vinyl chloride
  • AIDS and Epstein-Barr viral (EBV) infections

Types of soft tissue sarcoma

There are many different types of soft tissue sarcomas. Some examples of soft tissue sarcomas and the type of tissue where they started growing include:

  • Rhabdomyosarcoma, in skeletal muscles (the most common sarcoma in children)
  • Fibrosarcoma, in fibrous tissues such as tendons and ligaments
  • Leiomyosarcoma, in smooth muscle such as the stomach and bladder
  • Malignant peripheral nerve sheath tumor, in the protective covering of nerves
  • Liposarcoma, in fat cells (rare)

Symptoms of soft tissue sarcoma

Soft tissue tumors may show no symptoms in early stages. The most common sign is a painless lump or swelling under the skin. As sarcomas grow larger, they may press on nearby muscles, nerves, organs, and blood vessels and cause:

  • Pain, tingling, or numbness
  • Weakness
  • Trouble breathing

Because these symptoms also appear in other childhood conditions, they may or may not be a sign of soft tissue sarcoma. Your pediatrician will need to thoroughly examine your child to determine the cause of these symptoms.

How is soft tissue sarcoma diagnosed?

Children’s National has advanced imaging equipment available for diagnosis, staging, treatment, and follow-up for all bone and soft tissue sarcomas in children, adolescents, and young adults. In addition, the Children’s National sarcoma program is one of the few in the United States where patients can see a pediatric oncologist, orthopaedic oncologist, biologist, and physical therapist in one truly comprehensive visit.

In addition to a physical exam, your pediatrician may recommend one or more of the following tests to look for soft tissue sarcoma:

  • Blood and urine tests to measure organ function and evaluate their possible involvement
  • Diagnostic imaging, including CT, MRI, ultrasound, X-ray, and bone scans, to look for tumors
  • Biopsy, a tissue sample of the tumor that a lab pathologist can study to determine whether the growth is cancerous

Treatments for soft tissue sarcoma

There are several treatment options for children with soft tissue sarcomas, including:

  • Cancer surgery to remove the entire tumor and nearby tissue, if needed
  • Radiation therapy, including:
    • External beam using a machine to focus high-powered X-rays on the tumor
    • Brachytherapy (internal radiation) using tiny implants to deliver radiation directly into or very near the tumor
  • Chemotherapy with drugs that are delivered by mouth or vein
  • Targeted therapy with drugs that focus on cancer cells without damaging normal cells 

Children who have soft tissue sarcomas often respond better to treatment than adults and have a better prognosis.