Criteria for Urgent Referral
If clinical concerns, but doesn't appear to fit criteria, consider using A&G through ERS.
Suspicious Soft Tissue Mass:
- Size > 5cm
- Painful
- Increasing in size
- Deep to fascia, fixed or immobile
- Recurrence after previous excision
Primary Bone Tumour:
(Important: Please attach radiology report.)
- Radiological suspicion of a primary bone tumour based on evidence of bone destruction, new bone formation, soft tissue swelling and periosteal elevation.
- Patients 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 be investigated by the primary healthcare professional urgently.
- In older people metastases, myeloma or lymphoma, as well as sarcoma, should be considered.
Investigations:
- X-Ray
- Ultrasound Scan
- MRI
- CT Scan
- Histology Report
- Biopsy
- Excision
Referral Information
- Soft-tissue sarcomas (including abdominal and retroperitoneal) are managed by the East Midlands Sarcoma Service at NUH.
- Head and neck lumps of more than 3 weeks duration should be urgently referred to your local head & neck service in the first instance.
- Generalised lymphadenopathy in the presence of lymphocytosis and/or constitutional symptoms should be urgently referred to your local haematology service.
- Bone sarcoma referrals are triaged by the East Midlands Sarcoma Service at NUH.
- Bone sarcomas are managed by the Royal Orthopaedic Hospital (ROH), Birmingham.
- Patients with an x-ray suggestive of non-specific bone tumour should be urgently referred to their local service:
- Metastases: known Primary Cancer Team / Cancer of Unknown Primary Team
- Myeloma/Lymphoma: Haematology
- Acute fracture or neurology: discuss with local orthopaedic/spinal service.
- Patients with benign bone lesions should be routinely referred to their local orthopaedic/spinal service.
Significant Weight Loss Only?