Summary
In order to characterise soft tissue tumours, pathologists often utilise specialised
additional tests, or may seek opinions from subspecialist pathologists due to rarity
or complex morphology. Additionally, further review may be sought by subspecialist
sarcoma pathologists, such as those at our tertiary referral centre in Sydney, Australia.
The aim of this study was to examine the impact on diagnosis and management of this
external review, following diagnosis at a specialised sarcoma unit.
We collated the results of all additional external ancillary tests and specialist
reviews over a 10-year period and characterised the impact on the preliminary diagnosis
as ‘confirmed’, ‘new’ or ‘no clear diagnosis’. We subsequently noted whether the additional
findings resulted in a clinically significant change in management.
Of the 136 cases sent away, 103 patients had their initial diagnosis confirmed, 29
patients received a new diagnosis and, for four patients, the diagnosis remained uncertain.
Nine of the 29 patients receiving a new diagnosis had their management altered.
This study demonstrated that within our specialised sarcoma unit, the majority of
diagnoses provided by our specialist pathologists are confirmed on additional external
testing and review, but external review does provide additional assurance and benefit
to the patient.
Key words
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References
- Sarcoma diagnosis in the age of molecular pathology.Adv Anat Pathol. 2013; 20: 264-274
- An audit of the diagnosis and reporting of soft tissue sarcomas at the Lagos University Teaching Hospital.Niger J Clin Pract. 2018; 21: 1330-1336
- WHO Classification of Tumours of Soft Tissue and Bone.5th ed. IARC, Lyon2020
- Sarcoma: concordance between initial diagnosis and centralized expert review in a population-based study within three European regions.Ann Oncol. 2012; 23: 2442-2449
- The value of expert second opinion in diagnosis of soft tissue sarcomas.J Surg Oncol. 2008; 97: 40-43
- Histopathological diagnostic discrepancies in soft tissue tumours referred to a specialist centre.Sarcoma. 2009; 2009741975
- Histopathologic challenges: the second OPINION issue.Eur J Surg Oncol. 2019; 45: 12-15
- Clinical effect of molecular methods in sarcoma diagnosis (GENSARC): a prospective, multicentre, observational study.Lancet Oncol. 2016; 17: 532-538
- Impact of molecular analysis on the final sarcoma diagnosis: a study on 763 cases collected during a European epidemiological study.Am J Surg Pathol. 2013; 37: 1259-1268
- Advances in the pathology and molecular biology of sarcomas and the impact on treatment.Clin Oncol. 2017; 29: 471-480
- The genomics of undifferentiated sarcoma of soft tissue: progress, challenges and opportunities.Semin Cancer Biol. 2019; 61: 42-55
- Contemporary sarcoma diagnosis, genetics, and genomics.J Clin Oncol. 2018; 36: 101-110
- Fluorescence in situ hybridization for MDM2 amplification as a routine ancillary diagnostic tool for suspected well-differentiated and dedifferentiated liposarcomas: experience at a tertiary center.Sarcoma. 2015; 2015812089
- Malignant peripheral nerve sheath tumor is a challenging diagnosis: a systematic pathology review, immunohistochemistry, and molecular analysis in 160 patients from the French sarcoma group database.Am J Surg Pathol. 2016; 40: 896-908
- Loss of H3K27 trimethylation distinguishes malignant peripheral nerve sheath tumors from histologic mimics.Mod Pathol. 2016; 29: 4-13
- MUC4 is a highly sensitive and specific marker for low-grade fibromyxoid sarcoma.Am J Surg Pathol. 2011; 35: 733-741
- STAT6 immunohistochemistry is helpful in the diagnosis of solitary fibrous tumors.Am J Surg Pathol. 2014; 38: 552-559
- Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up.Ann Oncol. 2018; 29: iv51-iv67
- Clinical Practice Guidelines for the Management of Adult Onset Sarcoma.Australia and New Zealand Sarcoma Association (formerly known as the Australian Sarcoma Group), Sydney2013
- Changes in soft-tissue sarcoma treatment patterns over time: a population-based study in a country with universal and centralized healthcare.Sarcoma. 2019; 2019: 1-7
Article info
Publication history
Published online: April 07, 2023
Accepted:
January 14,
2023
Received in revised form:
December 22,
2022
Received:
June 29,
2022
Identification
Copyright
© 2023 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.