Information for GPs

Adults with an unexplained soft tissue lump in the extremities or trunk wall that is increasing in size should have an urgent ultrasound scan (within 14 days) and be subsequently referred on a 2WW Sarcoma referral pathway if sarcoma is suspected or if findings are uncertain and clinical concern persists [NICE NG12 guideline]. Other features of lumps that may cause clinical concern are:

Size > 5 cm

Deep to fascia, fixed or immobile

Painful

Suspected recurrence after previous excision

 

Please only refer your patient if an ultrasound scan has been performed

Details of the name & location of where the scan was conducted & radiology reports need to be attached to the referral; if you are unable to organise an ultrasound scan and there is significant clinical concern, please complete a referral and state *No ACCESS TO USS* on your referral form 

We use ultrasound images to triage referrals and enable straight to test pathways that expedite diagnosis for patients

 

Following 2WW referral, the first contact with patients will be virtual. During this appointment we will explore the clinical history, explain the outcome of our triage review and notify of any next steps that are recommended.

   

Adults with increasing, unexplained or persistent bone pain or tenderness, particularly pain at rest (and especially if not in the joint), or an unexplained limp or spontaneous fracture, should have an urgent x-ray (within 14 days) [NICE NG12 guideline]

• X-ray features of bone sarcoma include bone destruction, new bone formation, soft tissue swelling and periosteal elevation
  • Refer directly to Royal Orthopaedic Hospital Birmingham if X-ray and/or cross-sectional imaging suggests the possibility of bone sarcoma Oncology (cancer) (roh.nhs.uk)
  • Please seek advice from Radiology if you are unsure how to interpret the findings
• Patients with imaging suggestive of non-specific bone tumour should be urgently referred to the appropriate local service
  • Metastases- known primary cancer team / Non-specific - vague symptoms pathway
  • Myeloma/Lymphoma- Haematology
  • Acute fracture or neurology- discuss with Trauma & Orthopaedic/Spinal services