How is sarcoma diagnosed?

Diagnosis of sarcoma can be challenging. Often, special tests are performed on a tissue sample to understand the exact type of sarcoma, as there are more than 50 known subtypes of sarcoma— many of which can require specific treatment variations.

To diagnose a sarcoma, the doctor will begin with a thorough history and physical examination. The doctor might also use certain tests when making the diagnosis. These include:

  • X-ray: An X-ray will be taken to look for abnormal growths on the bones.
  • Computed tomography (CT): CT uses computers to combine many X-ray images into cross-sectional views of the inside of the body.
  • Magnetic resonance imaging (MRI): MRI uses large magnet, radio waves and a computer to create clear images of the body. This may be ordered for clearer pictures if an X-ray is not normal.
  • Bone scan: This test uses a small amount of radioactive material injected into the body to identify bone disorders, such as cancer.
  • PET scan: This test uses a special glucose tracer that is concentrated in cancer cells, and shows the areas in the body where the glucose is higher than normal, suggesting the presence of a rapidly growing tumor.
  • Biopsy: This is a procedure in which a piece of tissue from the affected area is removed so that it can be studied for cancer cells under a microscope.

What are the stages of sarcoma?

One of the biggest concerns about a cancer diagnosis is whether the cancer has metastasized (spread) beyond its original location. To determine this, the doctor assigns a number (1 through 4) to your diagnosis. The higher the number, the more the cancer has spread throughout your body. This is called "staging." The doctor needs this information in order to plan your treatment.

The following staging criteria apply to bone and soft tissue sarcoma only.

Soft tissue sarcoma stages:

  • Stage 1: Stage 1 is divided into stages 1A (smaller than five centimeters) and 1B (larger than five centimeters).
  • Stage 2: Stage 2 is divided into stages 2A (smaller than five centimeters) and 2B (larger than five centimeters) for soft tissue sarcomas of the head and neck, extremities (arms and legs), gastrointestinal tract and retroperitoneum (the part of the body behind the abdomen).
  • Stage 3: Stage 3 is divided into 3A or 3B based on the size of the tumor, the lymph node involvement or grade (based on the type of soft tissue sarcoma).
  • Stage 4 (metastatic): The tumor has spread to the lymph nodes in the extremities or to other parts of the body (for example, the lungs).

Bone sarcoma stages:

  • Stage 1: Stage 1 is divided into stages 1A (smaller than eight centimeters) and 1B (larger than eight centimeters).
  • Stage 2: Stage 2 is divided into stages 2A (smaller than eight centimeters) and 2B (larger than eight centimeters) for sarcomas of the head and neck, extremities (arms and legs), gastrointestinal tract and retroperitoneum (the part of the body behind the abdomen).
  • Stage 3: Stage 3 is divided into 3A or 3B based on the size of the tumor, the lymph node involvement or grade (based on the type of bone sarcoma).
  • Stage 4 (metastatic): The tumor has spread to the lymph nodes in the extremities or to other parts of the body
    (for example, the lungs).

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