Orthopaedic oncology is a specialised branch of orthopaedic surgery that focuses on the diagnosis, treatment, and management of soft tissue and bone lesions commonly found in the limbs.

Conditions include:

• Benign bone tumours (e.g. osteochondroma, giant cell tumour)
• Malignant bone tumours (e.g. osteosarcoma, Ewing sarcoma, chondrosarcoma)
• Malignant soft tissue sarcomas (e.g. liposarcoma, synovial sarcoma)
• Benign soft tissue lumps (e.g. lipomas and nerve sheath tumours)
• Metastatic bone disease (spread of cancers from breast, prostate, lung, etc)

Sarcoma

Around 5,300 new cases of sarcoma are diagnosed each year in the UK - which equates to 15 people every day.

Sarcomas are uncommon cancers that develop in the muscle, bone, nerves, cartilage, tendons, blood vessels, fatty and fibrous tissues.

There are around 100 different types of sarcoma and they commonly affect the arms, legs and trunk; however, they can impact almost any part of the body, on the inside or outside.

Sarcoma is therefore a general term and contains many different types of malignant tumour which are named depending on their original tissue of origin. Broadly they are grouped into soft tissue sarcoma and bone sarcoma.

Soft tissue sarcoma examples include:

• Liposarcoma (a malignant tumour of fat cells)
• Leiomyosarcoma (a malignant tumour of smooth muscle)
• Rhabdomyosarcoma (a malignant tumour of striated muscle cells)
• Fibrosarcoma (a malignant tumour of fibrous tissue)
• Synovial sarcoma (a malignant tumour of synovial tissue)
• Angiosarcoma (a malignant tumour of blood vessels)

Common signs to look out for:

• Painful swelling, lump or joint
• Increasing in size
• Lump bigger than 5cm
• Deep lump or swelling
• Recurrent lump from previous excision

Rapid-access diagnosis

If you’re worried you may have a soft tissue or bone lesion sarcoma, it’s important to consult your GP. They can refer you to a specialist, like OrthTeam’s Mr Amit Kumar, who has extensive experience in diagnosing and treating sarcomas, and is the only Orthopaedic Surgeon who offers treatment for it privately in Manchester.

Mr Kumar will perform a thorough clinical examination and assess whether additional tests are required, and works with specialist experts in radiology and pathology.

Various diagnostic procedures may be used to help determine the nature of the lump and guide the next steps.

Diagnostic tests include:

• X-ray
• Ultrasound (USS)
• Biopsy - (usually under ultrasound guidance)
• MRI (Magnetic Resonance Imaging)
• CT (Computer Tomography)
• Bone scan

Treatment

Treatment depends on the tumour’s grade (how closely the cancer cells resemble normal tissue) and stage (whether the cancer has spread to other parts of the body). As each case is unique, treatment plans are tailored to the individual and may vary from person to person. In most instances, surgery is the primary treatment, but it may be combined with radiotherapy either before (pre-operative) or after (post-operative) the operation.