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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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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