Soft Tissue Sarcomas Flashcards
(13 cards)
What is the clinical presentation of a soft tissue sarcoma?
Cutaneous or SQ mass
Usually nonpainful
Variable in consistency
Normal haired skin overlying
Variable growth rate
Can occur anywhere
Biologic Behavior: Soft Tissue Sarcoma
Locally invasive/infiltrative
Recurrence common after conservative excision
Relatively low metastatic rate
Visceral sarcomas typically more aggressive
How are soft tissue sarcomas diagnosed?
FNA (often poorly exfoliative or bloody)
Consider larger gauge needle or syringe aspiration
Excess blood or dry needle should prompt further investigation!!
Biopsy (incisional or excisional)
How are soft tissue sarcomas staged?
FNA
Biopsy
Thoracic rads
FNA regional LNs
Soft tissue sarcoma
What is the mainstay of treatment for soft tissue sarcomas?
Aggressive surgery
CT/MRI
WIDE local incision!!
3cm margins laterally, at least one fascial plane beneath, include bx tract
What are the ideal surgical margins for wide local excision of a soft tissue sarcoma?
3cm laterally
1 fascial plane below
Which type of soft tissue sarcomas have a higher metastatic rate?
High grade
Anaplastic
undifferentiated
How is a soft tissue sarcoma treated if you have incomplete surgical margins?
Second surgery
RT
Chemo
The best chance to cure is with the first surgery
What is the prognosis of a soft tissue sarcoma after incomplete excision and radiation therapy?
85% 3-year local control
50% 1 year local control if treating gross disease
What are the indications for chemotherapy for soft tissue sarcomas?
High grade (III), anaplastic, undifferentiated
What is the treatment for feline vaccine-associated sarcomas?
Wide local excision
5cm margins laterally, at least 2 fascial planes below
Recurrent tumors have higher metastatic rates
What is the 3-2-1 rule for managing lumps?
The lump persists for more than 3 months after vaccination
It becomes larger than 2 centimeters in diameter
It is increasing in size 1 month after vaccination
