All patients with a suspected/diagnosed soft tissue sarcoma should be referred to a Sarcoma Specialist Centre.

Please note that this diagnostic toolkit for soft tissue sarcoma is intended for healthcare professionals based in England, Wales and Northern Ireland only. For Scotland’s diagnostic toolkit, click here.

Clinical presentations

• Lump more than 5cm in size
• Lump increasing in size
• Deep to the fascia

Investigations

Adults

• Refer for urgent ultrasound (performed within 2 weeks)
• Refer for urgent appointment (within 2 weeks) to a sarcoma specialist centre if scan suggests soft tissue sarcoma, or if findings are uncertain and clinical concern remains

Children

• Refer for very urgent ultrasound (performed within 48 hours)
• Refer for very urgent appointment (within 48 hours) to a sarcoma specialist centre if scan suggests soft tissue sarcoma, or findings are uncertain and clinical concern remains

Note: MRI is more effective for investigating large deep lumps. MRI & biopsy (fine needle) should only be performed under the direction of a sarcoma specialist centre.