What are the UK imaging guidelines for pleomorphic sarcoma (malignant fibrous histiocytoma) of soft tissue?

Updated: Nov 07, 2018
  • Author: Gregory Scott Stacy, MD; Chief Editor: Felix S Chew, MD, MBA, MEd  more...
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Answer

Answer

Sarcoma specialists from the United Kingdom, including members of the British Sarcoma Group and NHS England Sarcoma Clinical Reference Group, also issued guidelines on management of STS.  Imaging recommendations include [6] :

  • Any patient with a soft tissue mass that is increasing in size or is >5 cm, whether or not painful, should be referred either for an urgent ultrasound scan or directly to a sarcoma diagnostic center.
  • If the ultrasound scan does not definitively confirm benign pathology, the patient should be referred for further investigation on an urgent suspected cancer referral pathway.
  • Ultrasound scan by a musculoskeletal radiologist should be considered as the first-line investigation and may be supplemented by ultrasound-guided core biopsy.
  • MRI and core needle biopsy are recommended prior to definitive surgery.
  • Imaging of the thorax by CT scan for lung metastases should be done before radical treatment; further staging may be considered depending on subtype and location of the sarcoma.

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