What are these tumours

  • Tumours of bones and soft tissues are uncommon but important.
  • Sarcomas occur at all ages, and can be very dangerous.
  • Early recognition and accurate management are essential to cure.

How do they present

  • Soft tissue tumours: usually present as a painless mass.
    • Almost any soft tissue mass can be a sarcoma.
    • Be suspicious if the mass is large, deep and/or growing rapidly.
  • Bone tumours: usually painful, and a mass may be present.
    • Some will present as pathological fractures.
    • Be suspicious of unexplained bone or joint pain for more than 6 weeks.

How do I confirm a diagnosis?

  • Soft tissue tumours: the investigation of choice is an MRI scan.
    • If you are highly suspicious, and don’t have access to a prompt MRI just refer it to a multidisciplinary team.
  • Bone tumours: the best investigation is a plain X-Ray.
    • It is not necessary to perform a biopsy prior to referral, and in fact this can spread the tumour locally if not done in the right anatomic plane.

When should I refer?

  • Soft tissue tumours: large, deep or rapidly growing tumours.
    • Small, superficial stable masses can be excised in the community and referred if sarcoma is detected on the pathology review.
  • Bone tumours: Orthopaedic oncologists will review any suspicious X-Ray.
    • If you are suspicious, consult with a multidisciplinary group in your area.

How do I refer?

  • There is an accessible list, under the Resources section of the MSK Oncology website, for members of the Canadian Orthopaedic Oncology Society (CANOOS), and the best way to contact their offices.
  • If the tumour is in the abdomen or another body site then contact a surgeon with sarcoma expertise in that body area.

What is the best management?

  • These tumours are best managed by multidisciplinary teams.
  • Multidisciplinary management improves survival and limb salvage.
  • Each patient will receive a customized treatment plan.
  • Treatment modalities include surgery, radiation therapy and chemotherapy.

What should I tell my patient to expect?

  • Your patient should expect to be seen within a week or two.
  • They should expect to be reviewed at a multidisciplinary conference.
  • They should expect to be told the exact nature of their condition and their treatment recommendations.
  • The vast majority of patients are managed with limb salvage surgery.
  • Most patients with these cancers can be cured, but not all.