Practice Easily Missed?

Soft tissue sarcoma

BMJ 2016; 352 doi: http://dx.doi.org/10.1136/bmj.i436 (Published 24 February 2016) Cite this as: BMJ 2016;352:i436
  1. N Eastley, clinical research fellow1 2 3,
  2. P N Green, GP principal4,
  3. R U Ashford, consultant orthopaedic and musculoskeletal tumour surgeon1 2 5
  1. 1East Midlands Sarcoma Service, Leicester Royal Infirmary, Leicester LE1 5WW, UK
  2. 2Leicester Orthopaedics, Leicester Royal Infirmary
  3. 3Department of Genetics, University of Leicester, Leicester LE1 7RH
  4. 4Jubilee Medical Practice, Syston Health Centre, Syston, Leicestershire LE7 2EQ, UK
  5. 5Academic Orthopaedics, University of Nottingham, Queen’s Medical Centre, Nottingham NG7 2UH, UK
  1. Correspondence to: R Ashford robert.ashford{at}sky.com

What you need to know

  • Consider soft tissue sarcoma with any unexplained lump larger than 4.3 cm (a golf ball) or any lump increasing in size, and undertake urgent ultrasound

  • Concerning clinical or ultrasound features of a soft tissue lump should prompt urgent (two week wait) referral to a sarcoma centre

A 45 year old woman presented to her general practitioner several times over nine months with a gradually enlarging, hard lump in her anterior thigh. An ultrasound scan showed a solid intramuscular mass in the anterior compartment of her thigh, prompting a two week wait referral to the regional sarcoma diagnostic clinic. Magnetic resonance imaging showed a large, heterogeneous intramuscular mass. Core biopsy confirmed a high grade soft tissue sarcoma, and staging computed tomography showed lung metastases. The patient underwent chemotherapy for metastatic disease, followed by resection of her primary tumour, but her disease relapsed and she died 16 months after diagnosis.

What is soft tissue sarcoma?

Soft tissue sarcoma is a heterogeneous group of malignancies. They account for 1% of cancers and have a five year survival of approximately 50%. They can occur at any age (although more than 65% occur in people aged over 50 years1) and in any part of the body.

How common are soft tissue sarcomas?

  • Approximately 3270 …

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