scholarly journals Delays in Referral of Soft Tissue Sarcomas

Sarcoma ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-7 ◽  
Author(s):  
G. D. Johnson ◽  
G. Smith ◽  
A. Dramis ◽  
R. J. Grimer
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Structured Interview ◽  
Medical Professional ◽  
Treatment Pathway ◽  
Median Delay ◽  
Service Delay ◽  
Surgical Ward ◽  
Specialist Centre ◽  
History Of

Introduction and aims. It is well established that soft tissue sarcomas (STSs) are more effectively treated in a specialist centre. However, delays in time taken for a patient to be referred to a specialist centre may lead to a poorer prognosis. This study aims to identify the length of these delays and where they occur.Patients and methods. Patients with a proven STS were included. They were recruited from both outpatient clinics and from the surgical ward of the Royal Orthopaedic Hospital (Birmingham, UK). A structured interview was used to take a detailed history of the patients' treatment pathway, before arriving at the specialist centre. Dates given were validated using the case notes.Results. The median time for the patient to present to a specialist centre from the onset of symptoms was 40.4 weeks. The median delay until presentation to a medical professional (patient delay) was 1.3 weeks. Median delay in referral to a specialist centre (service delay) was 25.0 weeks.Discussion. Medical professionals rather than patients contribute the greatest source of delay in patients reaching a specialist centre for treatment of STS. Adherence to previously published guidelines could decrease this delay for diagnosis of possible sarcoma. Steps should be taken to refer patients directly to a diagnostic centre if they have symptoms or signs suggestive of STS.

scholarly journals A rare case of paratesticular leiomyosarcoma

2012 ◽  
Vol 2 (1) ◽  
pp. 29 ◽  
Author(s):  
James Moloney ◽  
John Drumm ◽  
Deirdre M. Fanning
Keyword(s):  
Soft Tissue ◽  
Adjuvant Radiotherapy ◽  
Spermatic Cord ◽  
Soft Tissue Sarcomas ◽  
Solid Mass ◽  
Urological Malignancies ◽  
History Of ◽  
To Receive ◽  
Groin Swelling

Soft-tissue sarcomas of the genitourinary tract account for only 1-2% of urological malignancies and 2.1% of soft-tissue sarcomas in general. A 69-year-old male complained of a 4 month history of a painless right groin swelling during routine urological review for prostate cancer follow-up. Clinical examination revealed a non-tender, firm right inguinoscrotal mass. There was no discernible cough impulse. Computed tomography of abdomen and pelvis showed a non-obstructed right inguinal hernia. During elective hernia repair a solid mass involving the spermatic cord and extending into the proximal scrotum was seen. The mass was widely resected and a right orchidectomy was performed. Pathology revealed a paratesticular sarcoma. He proceeded to receive adjuvant radiotherapy. Only around 110 cases of leiomyosarcoma of the spermatic cord have been described in the literature. They commonly present as painless swellings in the groin. The majority of diagnoses are made on histology.

scholarly journals Smoking and Family Cancer History Are Associated With Sarcomas in A Japanese Population Study

2020 ◽  
Author(s):  
Yoshihiro Araki ◽  
Norio Yamamoto ◽  
Yoshikazu Tanzawa ◽  
Takahiro Higashi ◽  
Katsuhiro Hayashi ◽  
...  
Keyword(s):  
Family History ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Smoking Habit ◽  
Soft Tissue Sarcomas ◽  
High Grade ◽  
Cancer History ◽  
Family Cancer History ◽  
History Of ◽  
History Of Cancer

Abstract Background: Sarcoma is a rare cancer, and it is also the cause of the development of various kinds of sarcomas, such as gene abnormalities, which has recently becoming evident due to advances of genetic testing. The approach to solve the origin of diseases is essential to elucidate both the external environmental factors and the internal genetic factors. However, the lifestyle habits, lifestyle-related diseases, personal and family cancer history of sarcoma patients remain unclear.Methods: A total of 1320 sarcoma patients were enrolled in this study. A questionnaire on lifestyle habits, life-style diseases, and the patient’s personal and family cancer history was completed at presentation. A total of 1320 controls were selected by propensity score matching for age and gender. Smoking, drinking, obesity, hypertension, dyslipidemia and diabetes mellitus were compared. In addition, we investigated the incidence of a personal and family cancer history in sarcoma patients. Results: A smoking habit was the only independent risk factor for high-grade soft tissue sarcoma development in adults ≥20 years old (n=952), excluding low-grade and intermediate malignant soft tissue tumors (Odds ratio [OR], 2.45; 95% confidence interval [CI] 1.88-3.20, p<0.001). The ORs of high-grade liposarcoma and undifferentiated pleomorphic sarcoma (UPS) were 2.56 and 3.00, respectively. Eight percent of sarcoma patients had a personal history of another cancer. Thirty percent of soft tissue sarcoma patients had a family history of cancer in a first-degree relatives (malignant peripheral nerve sheath tumor, 52%; leiomyosarcoma, 46%). Conclusions: We confirmed that a smoking habit were associated with the development of high-grade soft tissue sarcomas. A family history of cancer might be associated with certain soft tissue sarcomas, but a further investigation will be necessary.

scholarly journals Variation of Second Cancer Risk by Family History of Retinoblastoma Among Long-Term Survivors

2012 ◽  
Vol 30 (9) ◽  
pp. 950-957 ◽  
Author(s):  
Ruth A. Kleinerman ◽  
Chu-ling Yu ◽  
Mark P. Little ◽  
Yi Li ◽  
David Abramson ◽  
...  
Keyword(s):  
Family History ◽  
Soft Tissue ◽  
Germline Mutation ◽  
De Novo ◽  
Soft Tissue Sarcomas ◽  
Second Cancer ◽  
History Of ◽  
Long Term Survivors

Purpose To evaluate the risk of second cancer (SC) in long-term survivors of retinoblastoma (Rb) according to classification of germline mutation, based on family history of Rb and laterality. Patients and Methods We assembled a cohort of 1,852 1-year survivors of Rb (bilateral, n = 1,036; unilateral, n = 816). SCs were ascertained by medical records and self-reports and confirmed by pathology reports. Classification of RB1 germline mutation, inherited or de novo, was inferred by laterality of Rb and positive family history of Rb. Standardized incidence ratios and cumulative incidence for all SCs combined and for soft tissue sarcomas, bone cancers, and melanoma were calculated. The influence of host- and therapy-related risk factors for SC was assessed by Poisson regression for bilateral survivors. Results We observed a relative risk (RR) of 1.37 (95% CI, 1.00 to 1.86) for SCs in bilateral survivors associated with a family history of Rb, adjusted for treatment, age, and length of follow-up. The risk for melanoma was significantly elevated for survivors with a family history of Rb (RR, 3.08; 95% CI, 1.23 to 7.16), but risks for bone or soft tissue sarcomas were not elevated. The cumulative incidence of SCs 50 years after diagnosis of bilateral Rb, with adjustment for competing risk of death, was significantly higher for survivors with a family history (47%; 95% CI, 35% to 59%) than survivors without a family history (38%; 95% CI, 32% to 44%; P = .004). Conclusion Rb survivors with bilateral disease and an inherited germline mutation are at slightly higher risk of an SC compared with those with a de novo germline mutation, in particular melanoma, perhaps because of shared genetic alterations.

scholarly journals Early symptoms of bone and soft tissue sarcomas: could they be diagnosed earlier?

2012 ◽  
Vol 94 (4) ◽  
pp. 261-266 ◽  
Author(s):  
A George ◽  
R Grimer
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcomas ◽  
Clinical Excellence ◽  
Bone Sarcoma ◽  
Definitive Diagnosis ◽  
Specialist Care ◽  
Early Symptoms ◽  
Specialist Centre ◽  
Delays In Diagnosis ◽  
Current Guidelines

INTRODUCTION Delays in diagnosis are common for patients with bone and soft tissue sarcoma (STS) despite guidance produced by the National Institute for Health and Clinical Excellence. This study set out to identify early symptoms experienced by patients and reasons for delays in making a definitive diagnosis. METHODS Retrospective interviews were carried out with 107 patients (66 with an STS and 41 with a bone sarcoma) presenting to a specialist centre. Symptoms were determined prior to definitive diagnosis and the occurrence of patient and doctor delays in reaching specialist care. RESULTS The median patient delay was 1 month while the median doctor delay was 3.2 months from first symptoms to diagnosis for all sarcomas. Forty-nine patients with STS (74%) presented initially to their general practitioner with at least one guideline feature to prompt urgent referral. Only 2 patients (4%), however, were referred directly to a sarcoma unit, with 21 (43%) referred to secondary care for investigation. Patients with a lump increasing in size exhibited longer patient delays while doctor delay was shorter for deep lumps. Thirty-six patients with a bone sarcoma (88%) presented initially with symptoms to prompt further investigation. Nevertheless, significant delays (3.9 months) were seen in reaching specialist care. Only 4 patients (10%) were referred directly to a sarcoma unit at first presentation, with 21 (54%) referred for further investigation elsewhere. CONCLUSIONS It is evident that awareness and referral of sarcomas remain poor. We suggest specific amendments to current guidelines and clearer referral pathways for patients. Furthermore, the need for robust education strategies is indicated, predominantly among healthcare professionals.

A High-Grade Primary Leiomyosarcoma of the Bladder in a Survivor of Retinoblastoma

2001 ◽  
Vol 125 (9) ◽  
pp. 1231-1234
Author(s):  
Sharon X. Liang ◽  
Yegappan Lakshmanan ◽  
Bruce A. Woda ◽  
Zhong Jiang
Keyword(s):  
Soft Tissue ◽  
Urinary Bladder ◽  
Soft Tissue Sarcomas ◽  
Common Type ◽  
Prior History ◽  
Adjuvant Radiation ◽  
High Grade ◽  
Cyclophosphamide Therapy ◽  
The Past ◽  
History Of

Abstract Second nonocular malignancies develop with increased incidence in patients with hereditary retinoblastoma. Osteosarcoma is by far the most common type with an incidence of up to 50%, followed by soft tissue sarcomas. Visceral leiomyosarcoma is extremely rare and only 2 cases have been reported in the past 2 decades, one in the liver and another one in the urinary bladder, both of which developed after cyclophosphamide therapy. Here we report a case of vesical leiomyosarcoma that was diagnosed in a 49-year-old woman 47 years after the diagnosis of a hereditary retinoblastoma. The patient's retinoblastoma was treated with unilateral enucleation without adjuvant radiation or chemotherapy. We believe that this is the first report of vesical leiomyosarcoma occurring in a patient with retinoblastoma without a prior history of radiation or chemotherapy. This report is significant not only because of the rarity of vesical leiomyosarcoma as a second nonocular tumor in retinoblastoma patients, but also because of the infrequency of vesical leiomyosarcoma in general. We also investigated the potential molecular pathogenesis of the leiomyosarcoma.

scholarly journals Should Soft Tissue Sarcomas be Treated at a Specialist Centre?

Sarcoma ◽  
2004 ◽  
Vol 8 (1) ◽  
pp. 1-6 ◽  
Author(s):  
A. A. Bhangu ◽  
J. A. S. Beard ◽  
R. J. Grimer
Keyword(s):  
Soft Tissue ◽  
Local Recurrence ◽  
Soft Tissue Sarcomas ◽  
Lower Grade ◽  
General Hospitals ◽  
Factors Affecting ◽  
District Hospitals ◽  
Specialist Centre ◽  
Retroperitoneal Tumors ◽  
Record Review

Objective. We have investigated whether there is evidence that patients with soft tissue sarcomas do better if treated in a specialist centre compared with district general hospitals.Patients. All patients diagnosed with soft tissue sarcomas who were residents of WMRHA between 1994 and 1996, with minimum follow up of 5 years, excluding head and neck or retroperitoneal tumors.Methods. We reviewed data from the Royal Orthopaedic Hospital Oncology Service (ROHOS) database and the Cancer Intelligence Unit (CIU) Database, with medial record review where necessary. Main outcome measures were local recurrence and overall survival.Results. A total of 260 patients were diagnosed as having STS over the 3-year period (incidence=1.62per 100000 per year): 37% of patients had the majority of treatment at the specialist centre under the care of three surgeons, whilst the other 63% were treated at a total of 38 different hospitals. The rate of local recurrence was 39% at the district general hospitals compared with 19% at the specialist centre despite the fact that tumours treated at the district hospitals were smaller and of lower grade. The most significant factors affecting survival were grade (high versus low) and depth of the tumour. Patients treated at the specialist centre had a small survival advantage after multivariate testing.Conclusion. Soft tissue sarcomas are rare. Centralization of treatment improves local control in all patients and survival in some. Appropriate mechanisms for ensuring that patients with soft tissue sarcomas are seen and treated at specialist centres should be developed.

scholarly journals Systemic Treatment for Soft Tissue Sarcoma: What is Standard, What is New

2018 ◽  
Vol 1 (Supplement) ◽  
pp. 64
Author(s):  
D.C. Jinga ◽  
D. Chetroiu
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Adjuvant Treatment ◽  
Kinase Inhibitors ◽  
Systemic Treatment ◽  
Growth Factor Receptor ◽  
Soft Tissue Sarcomas ◽  
High Grade ◽  
History Of ◽  
New Treatment

Abstract Soft tissue sarcoma (STS) is a biologically heterogeneous malignancy with over 50 subtypes. This solid tumor is one of the most challenging diseases to treat for the medical oncologist. STS often forms in the body’s muscles, joints, fat, nerves, deep skin tissues, and blood vessels. The natural history of high-grade STS is characterized by a strong tendency toward local recurrence and metastatic spreading, despite optimal initial strategies. The lung is the most common site of metastases, with poor prognosis. We present the current international guidelines for the adjuvant treatment and systemic treatment for advanced STS and the new discoveries. Many new molecular targeting drugs have been tried in the last ten years, and some were approved for soft tissue sarcoma. The first approved was Imatinib, as a treatment for gastrointestinal stromal tumors (GISTs). Following Imatinib, other tyrosine kinase inhibitors (TKIs) received the approval for GISTs such as Sunitinib and Regorafenib, and Pazopanib for non-GIST soft tissue sarcomas. In 2016, FDA approved the first monoclonal antibody that targets platelet-derived growth factor receptor (PDGFR)-α, Olaratumab. The new treatment demonstrates an overall survival advantage. In this review, we aimed to summarize the results from the most recent studies on adjuvant treatment for high-grade STS and systemic strategies for advanced STS.

Synovial Sarcoma in the Foot of a 5-Year-Old Child

2016 ◽  
Vol 106 (4) ◽  
pp. 283-288 ◽  
Author(s):  
Gary M. Lepow ◽  
Daniel L. Grimmer ◽  
Onya V. Lemar ◽  
Evan A. Bridges
Keyword(s):  
Soft Tissue ◽  
Synovial Sarcoma ◽  
Soft Tissue Sarcomas ◽  
Excisional Biopsy ◽  
Soft Tissue Tumors ◽  
Tibialis Posterior ◽  
Unexpected Finding ◽  
Tibialis Posterior Tendon ◽  
History Of ◽  
Soft Tissue Masses

The purpose of this case report is to present a rare finding of synovial sarcoma in a 5-year-old child. Most soft-tissue masses of the foot are too often presumed to be small and benign; therefore, compared with soft-tissue sarcomas, they are difficult to clinically differentiate and treat. A 5-year-old girl presented with a painful lesion that was diagnosed as synovial sarcoma after an excisional biopsy was performed. This was an unexpected finding of synovial sarcoma involving the tibialis posterior tendon of her right foot. The patient presented with an 8-month history of tenderness and an antalgic gait. We would like to encourage that all soft-tissue tumors of the foot be preoperatively evaluated with the aid of diagnostic imaging so that a well-planned biopsy assessment can be performed, with adequate margins excised.

Soft tissue sarcomas of the head and neck associated with surgical trauma

1995 ◽  
Vol 109 (2) ◽  
pp. 126-129 ◽  
Author(s):  
M. D. Dijkstra ◽  
A. J. M. Balm ◽  
R. T. Gregor ◽  
F. J. M. Hilgers ◽  
B. M. Lofrus
Keyword(s):  
Soft Tissue ◽  
Head And Neck ◽  
Causal Relationship ◽  
Soft Tissue Sarcomas ◽  
Surgical Trauma ◽  
Von Recklinghausen’S Disease ◽  
Von Recklinghausen's Disease ◽  
High Incidence ◽  
Recklinghausen's Disease ◽  
History Of

AbstractSoft tissue sarcomas in the head and neck are rare. Aetiological factors relating to these tumours have not yet been identified. The association with von Recklinghausen's disease andwith irradiation is however well recognized. In the literature it has been speculated that trauma may also play a role in the development of soft tissue sarcomas. In this article we present five patients with a history of surgical trauma at the site where a sarcoma later developed. Although we cannot prove a causal relationship, the relatively high incidence of possibly trauma-related soft tissue sarcomas in a series of 60 patients we have seen over a 30-year period, suggests that such a relationship could exist.

Continuum of Care Following Sports-Related Concussion

2020 ◽  
Vol 29 (3) ◽  
pp. 1389-1403
Author(s):  
Jessica Brown ◽  
Kelly Knollman-Porter
Keyword(s):  
Young Adults ◽  
Life Span ◽  
Sports Injuries ◽  
Continuum Of Care ◽  
Medical Professional ◽  
Structured Interviews ◽  
Youth Athletes ◽  
Speech Language Pathologist ◽  
History Of ◽  
Injury Reporting

Purpose Although guidelines have changed regarding federally mandated concussion practices since their inception, little is known regarding the implementation of such guidelines and the resultant continuum of care for youth athletes participating in recreational or organized sports who incur concussions. Furthermore, data regarding the role of speech-language pathologists in the historic postconcussion care are lacking. Therefore, the purpose of this retrospective study was to investigate the experiences of young adults with history of sports-related concussion as it related to injury reporting and received follow-up care. Method Participants included 13 young adults with history of at least one sports-related concussion across their life span. We implemented a mixed-methods design to collect both quantitative and qualitative information through structured interviews. Participants reported experiencing 42 concussions across the life span—26 subsequent to sports injuries. Results Twenty-three concussions were reported to a parent or medical professional, 14 resulted in a formal diagnosis, and participants received initial medical care for only 10 of the incidents and treatment or services on only two occasions. Participants reported concussions to an athletic trainer least frequently and to parents most frequently. Participants commented that previous experience with concussion reduced the need for seeking treatment or that they were unaware treatments or supports existed postconcussion. Only one concussion incident resulted in the care from a speech-language pathologist. Conclusion The results of the study reported herein shed light on the fidelity of sports-related concussion care management across time. Subsequently, we suggest guidelines related to continuum of care from injury to individualized therapy.

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