scholarly journals Histopathological Diagnostic Discrepancies in Soft Tissue Tumours Referred to a Specialist Centre: Reassessment in the Era of Ancillary Molecular Diagnosis

Sarcoma ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Khin Thway ◽  
Jayson Wang ◽  
Taka Mubako ◽  
Cyril Fisher

Introduction. Soft tissue tumour pathology is a highly specialised area of surgical pathology, but soft tissue neoplasms can occur at virtually all sites and are therefore encountered by a wide population of surgical pathologists. Potential sarcomas require referral to specialist centres for review by pathologists who see a large number of soft tissue lesions and where appropriate ancillary investigations can be performed. We have previously assessed the types of diagnostic discrepancies between referring and final diagnosis for soft tissue lesions referred to our tertiary centre. We now reaudit this 6 years later, assessing changes in discrepancy patterns, particularly in relation to the now widespread use of ancillary molecular diagnostic techniques which were not prevalent in our original study.Materials and Methods. We compared the sarcoma unit's histopathology reports with referring reports on 348 specimens from 286 patients with suspected or proven soft tissue tumours in a one-year period.Results. Diagnostic agreement was seen in 250 cases (71.8%), with 57 (16.4%) major and 41 (11.8%) minor discrepancies. There were 23 cases of benign/malignant discrepancies (23.5% of all discrepancies). 50 ancillary molecular tests were performed, 33 for aiding diagnosis and 17 mutational analyses for gastrointestinal stromal tumour to guide therapy. Findings from ancillary techniques contributed to 3 major and 4 minor discrepancies. While the results were broadly similar to those of the previous study, there was an increase in frequency of major discrepancies.Conclusion. Six years following our previous study and notably now in an era of widespread ancillary molecular diagnosis, the overall discrepancy rate between referral and tertiary centre diagnosis remains similar, but there is an increase in frequency of major discrepancies likely to alter patient management. A possible reason for the increase in major discrepancies is the increasing lack of exposure to soft tissue cases in nonspecialist centres in a time of subspecialisation. The findings support the national guidelines in which all suspected soft tissue tumour pathology specimens should be referred to a specialist sarcoma unit.

1997 ◽  
Vol 38 (4) ◽  
pp. 508-513
Author(s):  
M. Höglund

Purpose: The aim of this prospective investigation was to evaluate the accuracy of certain ultrasound characteristics in diagnosing 5 common types of soft-tissue tumour in the hand and forearm. Material and Methods: The study comprised 50 soft-tissue tumours, diagnosed by ultrasonography or histopathology as belonging to one of 5 soft-tissue tumour groups. The reported ultrasound diagnoses and the histopathological results were compared, and their sensitivity was calculated. A statistical model was applied to the prospective material. The first and second diagnostic alternatives were calculated for each specific tumour and for the whole prospective material. In the second part of this study, the prospective material was combined with a retrospective material of 96 tumours from a previous study. The combined material was analysed and the accuracy of the first and second diagnostic alternatives for each tumour and for the whole material was calculated. Results: The sensitivity for the prospective material was 84%. The correct diagnosis predicted by the model for the combined material was 56% for the first alternative and 79% when the second alternative was included. Conclusion: Ultrasonography is useful in the diagnosis of soft-tissue tumours of the hand.


2013 ◽  
Vol 64 (1) ◽  
pp. 1-1 ◽  
Author(s):  
Jason L Hornick ◽  
D Chas Mangham

2002 ◽  
Vol 10 (2) ◽  
pp. 173-178 ◽  
Author(s):  
G Kinoshita ◽  
M Matsumoto ◽  
T Maruoka ◽  
T Shiraki ◽  
K Tsunemi ◽  
...  

Purpose. To review cases of bone and soft tissue tumours of the feet managed at the Hyogo College of Medicine, Nishinomiya and Takarazuka Municipal Hospital, Takarazuka, Japan. Methods. Retrospective analysis of 83 patient records treated for bone and soft tissue tumours of the feet between 1974 and 2000. Results. There were 33 benign bone tumours, one primary malignant bone tumour, and 2 metastatic bone cancer. Marginal resection was performed in cases of osteochondroma and curettage in cases of other benign bone tumour. Despite below-knee amputation in the case of chondrosarcoma, the patient died because of pulmonary metastasis. Two patients with metastatic cancer also died, and 2 cases of osteochondroma and one of benign chondroblastoma recurred. There were 47 cases of soft tissue tumour. Treatment for benign soft tissue tumours was marginal resection; no cases recurred. In contrast, all patients with soft tissue sarcoma died after surgery. The majority of bone tumours were located in the toe and hindfoot areas, in the first and second decades of life, whereas soft tissue tumours occurred mainly in the midfoot area and in patients aged between 20 and 50 years. The sex distribution was almost even for bone tumours (male: female ratio, 19: 17), whereas about half as many males as females had soft tissue tumours (14:33). Conclusion. Bone and soft tissue tumours of the feet are uncommon. Most bone tumours are chondrogenic, but differential diagnosis of malignant from benign disease is difficult and prognosis is poor. Management of benign tumours by marginal resection has good prognosis, whereas prognosis of soft tissue sarcomas is very poor.


Sarcoma ◽  
2020 ◽  
pp. 93-118
Author(s):  
Vanessa Tran ◽  
John Slavin

2021 ◽  
Vol 80 (1) ◽  
pp. 2-3
Author(s):  
Jason L Hornick ◽  
Thomas Brenn

2017 ◽  
Vol 31 (3) ◽  
pp. 204-215 ◽  
Author(s):  
Kethesparan Paramesparan ◽  
Amit Shah ◽  
Winston J. Rennie

Sign in / Sign up

Export Citation Format

Share Document