Disease name: Smooth muscle sarcoma Disease overview Smooth muscle sarcoma is a malignant mesenchymal tissue tumor arising from the smooth muscle of the intestinal wall, the vascular smooth muscle of the intestinal wall, or the mucosal muscle of the intestinal wall, accounting for 5% to 10% of all soft tissue tumors. Among them, rectum is the most common, accounting for about 85% of smooth muscle sarcoma of the large intestine. Clinically, it is difficult to distinguish between benign and malignant smooth muscle tumors, mainly because the histological morphology sometimes does not agree with the biological behavior, and the phenomenon of benign morphology and malignant biological behavior often occurs. In addition to local infiltration of smooth muscle sarcoma into adjacent organs and tissues, hematogenous dissemination is the predominant route. Clinical manifestations Soft tissue smooth muscle sarcoma often occurs in middle-aged and elderly patients, with a high prevalence in the 40-60 year age group. It can also occur in young adults and is rare in children. It can occur in the retroperitoneum (the most common retroperitoneal malignancy recognized), peripheral soft tissues (most commonly in the lower extremities, especially the thighs) or in the wall of large vessels (mainly medium or large veins). The retroperitoneal region is the most common site of presentation, with larger tumors, and is seen mainly in women. Those that occur in the surrounding soft tissues and large vessels are more common in men. Soft tissue smooth muscle sarcoma often presents as a mass, and the latter may be painful when occurring in the peritoneum. The symptoms of smooth muscle sarcoma in the inferior vena cava depend on the location of the tumor. Disease Classification: General Surgery, Oncology Disease Description: Smooth muscle tumors of the stomach are classified as smooth muscle tumors, smooth muscle sarcomas, and smooth muscle cell tumors. Symptoms and signs The disease is often asymptomatic in the early stage; as the tumor increases and presses the tissues around the intestinal wall, it affects the defecation function and may cause constipation and poor defecation, and when the tumor is located above the dentate line and close to the anal canal, there may be anal pain, and when it presses the surrounding organs, there may be abnormal urination, pain and weakness in the sacrococcygeal region or lower limbs in men. If the tumor ulcerates, blood in stool, frequent stool and feeling of urgency will appear. In the early stage, the mucosa is not affected. After the tumor enlarges, there is often mucosal ulceration and ulcer-like symptoms. Etiology of the disease: The etiology is unknown. Pathophysiology: Smooth muscle sarcoma occurs in the fundus and body of the stomach and originates from the muscular layer of the gastric wall, but rarely from the smooth muscle of the mucosa and blood vessels. It swells and grows infiltratively into the subplasma or submucosa, forming a round or lobulated mass that does not affect the mucosa in the early stage. The tumor often enlarges with mucosal ulceration and ulcer-like symptoms, which can be relieved by acid-control agents. Diagnostic tests Gastroscopy is often difficult to diagnose, but barium X-ray, ultrasound gastroscopy and CT are helpful. ultrasound has a higher detection rate for shallow, large, extraluminal growths. The imaging diagnosis of smooth muscle sarcoma is not characteristic. The pathological diagnosis is mainly based on the morphological characteristics of the tumor under light microscopy combined with immunohistochemistry to confirm the diagnosis, if the tumor does not have the morphological characteristics of this type of tumor, the diagnosis should not be made only based on the immunohistochemistry results. Gastrectomy treatment should be performed, including resection of tumor tissue, and try to keep the cut edge free of tumor cells, and lymph node dissection is generally not recommended. Treatment and Prognosis Local recurrence and distant metastasis can occur in soft tissue smooth muscle sarcoma, but lymph node metastasis is rare. The most important prognostic factors are currently considered to be the location and size of the tumor. If the tumor is located in the retroperitoneum or is large, it is difficult to resect or cannot be completely removed and is prone to local recurrence and metastasis. Smooth muscle sarcoma of large vessels has a poor prognosis. Local recurrence and metastasis usually appear in the first few years after diagnosis and can occur up to 10 years later. The most common sites of metastasis for retroperitoneal smooth muscle sarcoma are the liver and lungs, with non-retroperitoneal tumors metastasizing primarily to the lungs. An extensive or radical surgical approach should be taken to remove the tumor. Magnetic induction therapy Magnetic induction therapy for tumors mainly uses the principle of heat production by ferromagnetic materials under alternating magnetic field to warm up tumor tissues to effective temperature for treatment purpose. Magnetic induction therapy has the characteristics of targeting, conformability, self-control temperature, internal heating, repeatability, and large temperature difference between normal tissue and tumor, etc. It is expected to overcome the shortcomings of previous local heat therapy methods for tumors and become a new effective means of treating tumors. The current indications for treatment are malignant soft tissue tumors (such as liposarcoma, fibrosarcoma, synovial sarcoma, rhabdomyosarcoma, hemangiosarcoma, etc.). Disease prevention: No special preventive measures. Dietary principles There are more and more treatment measures for smooth muscle sarcoma, including resection, radiotherapy, and some times, these measures fail to relieve the pain of smooth muscle tumor cell tumor patients, in fact, it is because the real reason of recovery is not found is that the body fluid is acidic, the acidic body fluid is not changed, and the mutated cells will not die, that is why the cancer cells metastasize and recur again after doing surgery and chemotherapy. To treat smooth muscle tumor cell tumor, we have to start from improving our own constitution and starve the tumor cells from the source. We should eat more alkaline foods to improve our acidic constitution and supplement the organic nutrients necessary for our body, so that we can recover our immunity while starving tumor cells to death. The common acidic foods and alkaline foods are as follows: 1. Strongly acidic foods: egg yolk, cheese, pastry made of white sugar or persimmon, oyster roe, wood fish, etc. 2.Medium acidic food: ham, bacon, chicken, tuna, pork, eel, beef, bread, wheat, cream, horse meat, etc. 3.Weakly acidic foods: white rice, groundnuts, beer, wine, fried tofu, seaweed, clams, octopus, mud fish. 4.Weakly alkaline food: red beans, radish, apple, collard greens, onion, tofu, etc. 5.Medium alkaline food: dried radish, soybean, carrot, tomato, banana, orange, melon, strawberry, egg white, dried plum, lemon, spinach, etc. 6.Strongly alkaline foods: chamagoo, grapes, tea, kelp buds, kelp, lemon, etc. For patients with smooth muscle tumor cell tumor, diet is very crucial. Kidney cancer is mainly caused by acid-base, so in patients’ diet, it is to eat alkaline food often to prevent the accumulation of acidic waste, because the acidified body fluid environment is a fertile soil for normal cell mutation, and adjusting the acid-base balance of body fluid is an effective way to prevent smooth muscle tumor cell tumor. The dietary principles of smooth muscle sarcoma: 1. In the diet of smooth muscle sarcoma patients, if the desirable food can be reasonably matched, it will be of great help to patients during treatment or during the post-operative recovery period. Beneficial smooth muscle sarcoma patients’ diet: appropriate to eat lean pork, duck, eggs, lotus, cabbage, tomatoes, cucumber, eggplant, celery, tofu, apples, pears, bananas, watermelon, melon, persimmons, walnuts, cooked peanut rice, pine nuts can eat, eat more fresh vegetables. 2, can not eat food with too high estrogen content, which will lead to the accelerated development of the tumor and may also increase the chances of recurrence after surgery. The diet that hinders the recovery progress of smooth muscle sarcoma patients are: spicy and stimulating food, beef and mutton, dog meat, chili, chicken, fatty meat, fish, grapes, pumpkin, coffee, parsley, milk, yogurt, amaranth, honey, tea water, green onion, garlic, white radish, cola, seafood, green beans, soft drinks, ice cream, tobacco, alcohol and acidic, greasy food. Anti-seasonal vegetables should not be eaten. Residual gastric smooth muscle sarcoma diet note: 1, chew slowly: food in the mouth to stimulate oral secretion of saliva (containing enzymes conducive to the digestion of sugar), chew carefully, can become smaller food particles, saliva and food fully mixed, replacing part of the stomach function. Slow swallowing refers to slow swallowing and long swallowing intervals to prevent rapid swallowing of large amounts of food from causing panic, dizziness and other dumping syndromes (more on this later). 2, a small number of meals: postoperative residual stomach or pick up the volume of the intestinal segment can not be compared with the previous, the body has to go through a longer period of time to adapt to this change. Clinical experience shows that it takes at least 8-10 months to return to a normal diet of three meals per day. Start meals, 5-8 times a day, at 50-100 g each time, and gradually increase the intake and decrease the number of meals according to the patient’s tolerance (no abdominal distension and discomfort is considered good tolerance). Due to individual differences, the process of adaptation is different. 3.Diversification of diet: The variety of food can be chosen according to the patient’s dietary preferences and habits, but attention should be paid to eating as much nutritious, easy-to-digest high protein, high vitamin diet. For example, fish, eggs, fresh vegetables, fruits (preferably juiced) and so on. Attention should be paid to iron supplementation because after gastrectomy, the effect of gastric acid on iron is lost (turning trivalent iron into divalent iron), resulting in impaired absorption. You can take some iron supplements orally under the guidance of a doctor, use an iron pot in your daily life, and eat more iron-rich foods, such as animal liver, spinach, and bean products. Drinking some yogurt is also beneficial. 4.Eating position: for surgery to remove the gastric inlet, prevent food reflux after eating and keep sitting position and slope position; for surgery to remove the gastric outlet, prevent food from running down quickly after eating, lie down and rest for about 20 minutes before free position. 5, after the meal follow the doctor’s advice to use some drugs, such as digestive drugs, vitamin B12, folic acid, etc., which can help digestion and absorption and prevent the occurrence of anemia. For fried, spicy and stimulating food, raw, cold and hard food should also be abstained from. Foods that are too hot, too sweet and too salty should also be appropriately restricted. Finally, smooth muscle sarcoma of the remnant stomach should be differentiated from various epithelial carcinomas of the remnant stomach, and pathological examination is usually required for a definite diagnosis. The main sites of metastasis are lung and liver. Safety of medication 1. It mostly occurs in 29 to 55 years old; 2. The 5-year survival rate of this disease is 20-25% after surgery. If timely eradication, patients can mostly survive for a long time. The difference between smooth muscle tumor and smooth muscle sarcoma Smooth muscle tumor is a benign tumor of smooth muscle cells of the skin. It can arise from vascular smooth muscle, lissencephaly, and smooth muscle of the breast or scrotum. The onset of disease may be genetically related. Smooth muscle sarcomas are malignant mesenchymal tissue tumors that arise from the smooth muscle of the intestinal wall, the vascular smooth muscle of the intestinal wall, or the mucosal muscle of the intestinal wall. They are most common in the rectum and account for approximately 85% of smooth muscle sarcomas of the large intestine. Clinically, it is difficult to distinguish between benign and malignant smooth muscle tumors, mainly because the histological morphology sometimes does not agree with the biological behavior, and the phenomenon of benign morphology and malignant biological behavior often occurs. In addition to local infiltration of smooth muscle sarcoma into adjacent organs and tissues, hematogenous dissemination is the predominant route.