Diagnosing Soft Tissue Sarcoma

NYU Langone specialists are experts at diagnosing the many types of soft tissue sarcoma in adults. This form of cancer arises from the soft tissues of the body, including the muscles, tendons, connective tissues, fat, blood vessels, nerves, or joint tissues. Because there are more than 50 types of soft tissue sarcoma, it’s critical to your care that your doctors have a full understanding of these tumors. Specialists at NYU Langone’s Stephen D. Hassenfeld Children’s Center for Cancer and Blood Disorders also diagnose and treat sarcomas in children.

As a soft tissue sarcoma grows, it may cause a lump or swelling, which is often painless. Symptoms vary, depending on the part of the body affected. For example, tumors in the abdomen can cause vomiting and constipation that persists beyond a few days; those in the head and neck can cause problems with swallowing that don’t go away or get worse over several days. There may, however, be no symptoms at all.

Risk factors for soft tissue sarcoma are largely unknown, with the exception of some rare inherited conditions that raise the risk of cancer, including Li–Fraumeni syndrome, neurofibromatosis type 1, and retinoblastoma, a rare eye tumor that’s present at birth.

In addition to asking you about your symptoms and medical history, doctors at NYU Langone use the most up-to-date technologies and tests to detect and diagnose soft tissue sarcomas.

Our doctors schedule an initial consultation with you within two days of your calling our center. They diagnose or confirm a diagnosis of sarcoma quickly, allowing you to start treatment within a week of your first visit. Starting treatment as soon as possible gives you the best chance of managing the sarcoma. Our doctors may recommend some of the following tests.

MRI Scans

Using a magnetic field and radio waves, an MRI scan creates detailed three-dimensional images of the structures in your body. This test allows your doctor to determine whether a soft tissue sarcoma has developed from muscle, fat, or other tissue.

CT Scans

This form of X-ray uses a computer to create cross-sectional, three-dimensional pictures, offering doctors various views of a tumor. CT scans can help your doctor determine if cancer has spread to other organs, such as the lungs.

PET/CT Scans

Your doctor may use a PET/CT scan, which can generate images of the entire body, if there is a possibility that the cancer has spread. The PET scan portion of this test requires the injection of radioactive glucose (sugar) into a vein. The radioactive sugar tends to collect in the soft tissue sarcoma and any areas where the cancer has spread, and these areas show up on the PET scan. These images are combined with the cross-sectional, three-dimensional images from a CT scan.

Biopsy and Tissue Testing

A biopsy involves the removal of tissue from the body for extensive molecular and genetic laboratory tests and examination under a microscope for signs of cancer. These tests can help your doctor determine the type of soft tissue sarcoma that’s present and the therapies that may be most successful.

For example, our doctors may look for changes in the chromosomes—the portions of cells that house genetic material—of soft tissue tumors. Certain genetic changes point to different types of sarcoma.

They may also study the antigens, or substances that the body recognizes as foreign, in the tissue. Different types of sarcoma can produce different types of antigens, usually proteins. High levels of specific proteins in tumor tissue can help doctors diagnose the sarcoma subtype.

Needle Biopsy

Doctors may use a core needle biopsy to get a sample of a soft tissue sarcoma. This type of biopsy uses a large needle to remove a portion of tissue. If a tumor is deep within the body, a needle biopsy may be performed under the guidance of imaging techniques such as ultrasound, which uses sound waves to create pictures on a monitor, or a CT scan.

Using a local anesthetic, an interventional radiologist carefully inserts and withdraws the needle using this image guidance.

Surgical Biopsy

Sometimes, diagnosing a soft tissue sarcoma using tissue from a needle biopsy can be challenging. If so, your doctor may perform a surgical biopsy in an operating room. This involves removing a large portion of tumor tissue through a surgical incision.

A surgeon may fully remove the tumor, a procedure called an excisional biopsy, if it is pressing on or causing damage to a nearby vital organ. If the tumor is growing in or around nearby blood vessels, NYU Langone vascular surgeons can help remove the growth and preserve or repair veins and arteries.

Both incisional and excisional biopsies usually require general anesthesia.