Current RMA Instruments

Changes from previous Instruments

SOP Bulletin 238

ICD Coding

• ICD-10-AM Codes: C22.3, C22.4, C32.3, C48, C49, C54.2, C96.2, C96.4, C96.8

Brief description

Soft tissue sarcomas are a group of primary malignant neoplasms arising in "soft" connective tissue (e.g. muscle, tendon, ligaments, dermis, fat, blood vessels, fibrous tissue, nerve sheath, histiocytic, synovial and non-skeletal cartilage) but not bone or articular cartilage.  Soft tissue sarcomas are uncommon, making up < 1% of adult cancers.

Confirming the diagnosis

The diagnosis is based on histopathology of a biopsy or excised lesion.

The relevant medical specialist is an oncologist.

Additional diagnoses covered by SOP

• Angiosarcoma
• Atypical fibroxanthoma
• Chondrosarcoma of non-skeletal cartilage (nose, ear etc)
• Dendritic cell sarcomas:
  • interdigitating (dendritic cell) sarcoma
  • Langerhans cell sarcoma
  • follicular dendritic cell sarcoma
• Ewing sarcoma arising in soft tissue
• Fibrosarcoma
• Haemangiosarcoma
• Leiomyosarcoma
• Liposarcoma
• Lymphangiosarcoma
• Malignant fibrous histiocytoma
• Malignant mast cell tumour (mast cell sarcoma)
• Malignant mixed mullerian tumours
• Malignant nerve sheath tumour
• Malignant schwannoma
• Mullerian adenosarcoma
• Neurosarcoma

• Rhabdomyosarcoma
• Synovial sarcoma
• Histiocytic sarcoma (malignant histiocytosis);
• Malignant odontogenic tumours;
• Atypical fibroxanthoma; and
• Mullerian adenosarcoma;

Conditions not covered by SOP

• Carcinosarcoma (malignant mesodermal mixed tumour or malignant mixed Mullerian tumour)
• Chondrosarcoma, skeletal* - Malignant neoplasm of bone and articular cartilage SOP
• Ewing sarcoma of bone* - Malignant neoplasm of bone and articular cartilage SOP
• Kaposi sarcoma* - Kaposi sarcoma SOP
• Lymphosarcoma* - Non-Hodgkin lymphoma SOP
• Mesothelioma* - Mesothelioma SOP
• Osteosarcoma* - Malignant neoplasm of bone and articular cartilage SOP
• Reticulosarcoma* - Non-Hodgkin lymphoma SOP
• Benign neoplasms – Meningioma, neuroma
• Haemopoietic neoplasia – Leukaemia * 
• Hodgkin's lymphoma* - Hodgkin lymphoma SOP
• Myeloid sarcoma and grandulocytic sarcoma
• Myeloma and malignant plasma cell neoplasms * - Myeloma SOP
• Malignant neoplasm of articular cartilage (chondrosarcoma) * - malignant neoplasm of bone and articular cartilage SOP
• Malignant neoplasm of bone (osteosarcoma) * - Malignant neoplasm of bone and articular cartilage SOP
• Malignant neoplasm of brain or cerebral meninges *
• Malignant neoplasm of larynx* - Malignant neoplasm of the larynx SOP
• Non-Hodgkin lymphoma*- Non- Hodgkin lymphoma SOP
• Primary myelofibrosis * - Primary myelofibrosis SOP

* another SOP applies

Clinical onset

Soft tissue sarcomas usually present as a gradually enlarging painless mass. There may be symptoms associated with the site of the tumour or compression of adjacent structures.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  Treatment is tailored for the circumstances of an individual case.  The outcome also varies widely depending on tumour type, stage and grade.