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Sarcoma of the Head and Neck

What is a sarcoma of the head and neck?

Sarcomas are relatively uncommon tumors. They are classified based on the specific tissue from where the tumor originates. There are more than 30 subtypes of sarcomas, and about 15 to 20 percent of sarcomas occur in the head and neck. Most of these sarcomas—about 80 percent—originate in soft tissue, and about 20 percent arise from bone.

Among sarcomas of the head and neck, the most common sites of origin are the paranasal sinuses and the neck.

About 80 percent of head and neck sarcomas occur in adults.

More Information About Sarcoma from Johns Hopkins Medicine

Sarcoma Treatment: Answers from Oncologists Nita Ahuja and Carol Morris

A sarcoma diagnosis can be scary. Learn about sarcoma treatment options and prevention of sarcoma recurrence from experts at the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center.

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What are the symptoms of a head and neck sarcoma?

The most common symptoms of a sarcoma of the head and neck are:

  • A painless lump

  • A facial or neck mass

  • Hoarseness

  • Unilateral obstruction

  • A nasal mass

  • Epistaxis

  • Change in voice

  • Weight loss

  • Difficulty or painful swallowing

What are the risk factors associated with sarcomas of the head and neck?

The only known risk factors for sarcomas of the head and neck are previous exposure to radiation (often in areas previously radiated for other cancers), genetic conditions such as Li-Fraumeni syndrome and osteosarcoma, and medical conditions such as lymphedema and angiosarcoma.

How is a head and neck sarcoma diagnosed?

A thorough head and neck exam is the first step toward making a diagnosis. A head and neck surgeon will perform a full exam, including evaluation of the upper airway. If a mass is suspected, an MRI and/or a CT scan may be ordered to demonstrate the extent of tumor involvement. A CT scan is used to determine bony involvement and tumor calcification. Contrast material infusion is usually required to fully appreciate the relationship of the tumor to adjacent vessels. The information obtained from a CT scan and an MRI scan is complementary, and both studies are often required in the evaluation of extensive lesions.

Occasionally, imaging findings can suggest the correct diagnosis, but an actual diagnosis requires a biopsy for pathology evaluation. If sarcoma is diagnosed, a PET scan may be ordered to determine if the cancer has spread.

How is a sarcoma of the head and neck treated?

Treatment of sarcoma usually requires a multimodality—more than one treatment—approach. With the exception of rhabdomyosarcoma, surgery is an important part of treatment, but it is usually used in conjunction with radiation and sometimes chemotherapy. Rhabdomyosarcoma is treated with chemotherapy and radiation. The exact treatment recommendation will vary based on the specific histologic type of sarcoma, the site, the size and the extent of disease—whether it is localized, regional or distant.

Reviewed by Dr. Christine Gourin from the Department of Otolaryngology-Head and Neck Surgery

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