Role of the pathologist in the management of soft-tissue sarcomas

The contribution of the pathologist to the management of soft-tissue sarcomas is threefold. First, and most important, is to establish the correct pathological diagnosis which should include the histologic type, subtype and grade of the tumour. This information, correlated with the size, site, clinical and radiologic presentation, is the key factor in determining the biologic behaviour of the tumour. As soft-tissue sarcomas frequently demonstrate histologic variability from one area to another, biopsy with computed tomography or radiologic guidance and adequate sampling is essential. Second, careful marking of the surgical resection margins in consultation with the surgeon is necessary to determine the completeness of excision. Third, examination of the resected specimen may also provide useful information on the sensitivity of the sarcoma to any previous radiation or chemotherapy which the patient may have received.