Posttreatment Assessment of Soft Tissue Tumors

More than 50% of malignant soft tissue tumors recur locally [2, 6]. There are several reasons for these disastrous results. Since benign tumors are 100-fold more frequent than malignant ones [6], the latter are frequently not suspected until after initial surgery, resulting in inadequate margins and microscopic residual nodules. The general surgeon who operates on many benign soft tissue masses takes tremendous precautions to preclude functional sequelae in patients. Most often he attempts to enucleate the lesion, particularly as most malignant tumors look macroscopically well limited, with a pseudocapsule, giving the erroneous impression of being benign. In fact, however, multiple, sometimes small, nonpalpable satellite nodules, often at the periphery of the main mass are discovered only at histologic examination after the operation is over, and these tiny lesions may account for the frequency of local recurrence. The histologic analysis of malignant soft tissue tumors is a formidable task, for more than 50 subgroups have been recognized [6]. In practice, every malignant soft tissue lesion (because of size or location criteria) should be sent to a reference center for evaluation and biopsy.