Soft Tissue Sarcomas

Soft tissue sarcomas are a rare and heterogeneous group of tumors representing less

than 1% of all adult malignancies. Sixty percent of soft-tissue sarcomas occur in the

extremities making them the commonest site.

Biopsy

- Biopsy diagnosis is mandatory

- Biopsy to be done only after all local imaging is completed

- In most cases a core needle biopsy is adequate ( it may need to be image guided depending on anatomical location of lesion)

- Immunohistochemistry confirmation desirable, may need additional cytogenetic and molecular studies

Staging

- Local X-Ray

- MRI

- X-Ray Chest / CT Scan (CT chest recommended in high grade sarcomas)

- Ultrasonography of abdomen pelvis (consider abdomino-pelvic CT) in myxoid / round cell liposarcoma, angiosarcoma, leiomyosarcoma, epithelioid sarcoma and synovial sarcoma

- Consider MRI spine for myxoid / round cell liposarcoma

- Consider CNS imaging for alveolar soft part sarcoma and angiosarcoma

Whoops excision -

Tumors referred after prior excision with inadequate or unknown margins need to be considered for re-excision with similar guidelines as primary tumors.

Indications for Radiotherapy -

Radiotherapy may be delivered either as pre or postoperative radiotherapy depending on surgeon/institution preference.