How do I know if I have a Sarcoma?

How do they present? What symptoms do patients with sarcoma have?

Most will present to a doctor with a growing mass.

sts clinical pic
Medial thigh soft tissue sarcoma

Bone sarcomas typically present with pain and on occasion as a fracture through the weakened area of bone involved. The pain starts off very mild and frequently is ignored until it becomes progressively more severe and frequent. Many will have symptoms for 3-6 months before diagnosis.

ewings xr
Humerus radiograph with classic findings of a bone sarcoma
path frx ewings
Pathologic fracture through a bone sarcoma

In general, sarcoma patients are not sick when they have localized (only present in one location) disease that has not spread.

Because these tumors are rare, many practicing physicians will never see or diagnose a sarcoma. There is frequently a delay in diagnosis because of a lack of awareness. Any growing mass (lump or bump) should be evaluated by a physician. If the mass is deep (below the fascia that covers muscle) and larger than a golf ball it should be worked up with imaging (MRI, radiographs, etc…) prior to biopsy or removal.

sarcoma golfball

What are the most common bone sarcomas?


Ewing’s sarcoma


What are some common soft tissue sarcomas?

Undifferentiated pleomorphic sarcoma (previously called malignant fibrous histiocytoma)


Synovial sarcoma






There are roughly 50 different subtypes of soft tissue sarcomas. The specific type has little bearing on treatment for a majority of patients. What is more important is the grade of the tumor. A pathologist who looks at the tumor under a microscope is responsible for the grading. Less aggressive tumors are low-grade and more aggressive tumors are high-grade. Knowing the grade helps the treating team determine which treatment methods should be employed.

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