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Sarcomas (Soft Tissue Sarcomas and Osteosarcoma): Symptoms, Diagnosis and Treatment
Sources reviewed by: Assoc. Prof. Dr. Ali OğulLast updated: October 2026
Soft tissue sarcomas and osteosarcoma: symptoms, biopsy and diagnosis, surgery, radiotherapy and chemotherapy options. Medical oncology in Mersin.
Key information
| Definition | Rare tumours arising from supporting tissues such as muscle, fat, connective tissue and bone |
|---|---|
| Main risks | Previous radiotherapy, some hereditary syndromes |
| Common symptoms | Growing lump, bone pain and swelling that worsen at night |
| Diagnosis | MRI, properly planned biopsy, chest CT |
| Treatment | Surgery, radiotherapy, chemotherapy, subtype-specific treatments |
What are sarcomas?
Sarcomas are rare cancers that develop from supporting tissues such as muscle, fat, connective tissue, blood vessels and bone. There are more than 50 subtypes of soft tissue sarcoma; among bone sarcomas, osteosarcoma is seen mostly in adolescents and young adults. Because they are rare and diverse, it is recommended that diagnosis and treatment be planned by a multidisciplinary team experienced in sarcoma, preferably before treatment starts [1][2].
Risk factors
In most sarcomas there is no clear cause. Previous radiotherapy, Li-Fraumeni syndrome, hereditary retinoblastoma, neurofibromatosis type 1 and some chemical exposures are risk factors. Osteosarcoma is more common during adolescence, when bone growth is rapid, and in older people with Paget’s disease [2][3].
What are the symptoms?
Soft tissue sarcomas are usually noticed as a painless, gradually growing lump; any lump larger than 5 cm, deep-seated or growing should be assessed. In osteosarcoma there is pain in the bone, often around the knee or shoulder, that gets worse at night, together with swelling. Sarcomas inside the abdomen may cause no symptoms for a long time [1][3].
Most of these complaints can also be caused by other conditions; complaints that persist or get worse need to be assessed by a doctor.
How is it diagnosed?
After imaging the lump with MRI, a biopsy is performed; it is recommended that the biopsy be done in a way that fits the later surgical plan and, if possible, at a centre with a sarcoma team. Molecular tests may be needed in pathology to determine the subtype. Chest CT is used for lung spread, and bone scintigraphy or PET-CT for bone sarcomas [1][4].
Staging
Staging follows the AJCC TNM system according to location; tumour size, depth, histological grade and spread are decisive [1][4].
Treatment options
- Surgery: In soft tissue sarcomas the main treatment is removal of the tumour with a margin of healthy tissue. In bone sarcomas, limb-sparing surgery is preferred whenever possible.
- Radiotherapy: May be given before or after surgery in high-grade or large soft tissue sarcomas.
- Osteosarcoma: Chemotherapy before and after surgery (high-dose methotrexate, doxorubicin, cisplatin – MAP) is the standard approach.
- Systemic treatment in soft tissue sarcomas: Chemotherapy before/after surgery in selected high-risk patients; in advanced disease, options such as doxorubicin-based treatments, ifosfamide, gemcitabine + docetaxel, trabectedin, eribulin or pazopanib are used according to subtype.
- Subtype-specific treatments: Targeted drugs such as imatinib are used for gastrointestinal stromal tumour (GIST); GIST is considered a separate disease [4][5].
Treatment is planned individually, taking into account the stage, tumour characteristics, general condition and the patient’s preferences. Not every option listed here is suitable for every patient.
Recent developments
The growing number of subtype-specific treatments (e.g. targeted drugs and immunotherapy in some rare sarcomas) has increased the importance of molecular diagnosis in sarcoma. Because these tumours are rare, clinical trials and collaboration between centres are especially important [4][5].
Support and follow-up during treatment
During treatment, not only the anti-cancer drugs but also the patient’s general condition is monitored. Nausea, fatigue, loss of appetite, pain, infection risk and changes in mood are asked about at every visit; when needed, preventive medication, nutritional support, physiotherapy and psychosocial support are planned. In situations such as fever, shortness of breath, uncontrollable diarrhoea or vomiting, or new severe pain, it is advisable to contact the treatment team without waiting for the scheduled visit. Herbal products and supplements can interact with some cancer drugs, so the treatment team should be consulted before using them.
For high-grade tumours, imaging of the tumour site and lungs is carried out every 3–4 months in the first years and less often thereafter.
Frequently asked questions
No. The vast majority of soft tissue lumps are benign (e.g. lipoma). However, lumps larger than 5 cm, deep-seated or growing should be assessed.
If sarcoma is suspected, it is recommended that the biopsy be planned with the surgery in mind and, if possible, done at a centre with a sarcoma team; an inappropriate biopsy can make later surgery more difficult.
In most patients, preoperative chemotherapy and modern surgical techniques make limb-sparing surgery possible; the decision is made with the orthopaedic oncology team.
GIST is a type of sarcoma that develops from the wall of the digestive tract; however, its treatment is different and it is mostly managed with targeted drugs.
Call +90 530 250 54 85 or write to the same number via WhatsApp. The outpatient clinic is open Monday to Friday, 08:00–16:00.
At the medical oncology outpatient clinic of Mersin University Faculty of Medicine Oncology Hospital, Çiftlikköy Campus, 33110 Yenişehir/Mersin, Türkiye. The assessment is done in person.
When needed, yes. The multidisciplinary tumour board meets every Friday from 09:00 to 13:00, and the sequence of surgery, radiotherapy and drug treatment is planned jointly.
Yes. A second opinion is a common way to clarify a treatment plan. Bring your pathology, imaging and discharge reports to the clinic for the assessment.
Pathology report, imaging reports and, if possible, the image CDs, discharge summary, recent blood tests and a list of the medicines you take. Translated copies are helpful if your documents are not in Turkish or English.
Medical oncology consultation for sarcoma in Mersin
If you have been diagnosed with sarcoma, or your diagnostic work-up is ongoing, you can apply for a medical oncology consultation with Assoc. Prof. Dr. Ali Oğul at Mersin University Faculty of Medicine Oncology Hospital (Çiftlikköy Campus, 33110 Yenişehir/Mersin, Türkiye). Medical oncology covers the planning of drug treatments such as chemotherapy, targeted therapy, immunotherapy and hormone therapy, the monitoring of side effects and follow-up after treatment. The hospital has a day treatment unit where drug treatments are given.
Treatment decisions are made by a team. When needed, patient files are discussed at the multidisciplinary tumour board, which meets every Friday from 09:00 to 13:00 with specialists from the relevant departments.
For appointments, call +90 530 250 54 85 or send a WhatsApp message to the same number with your name, diagnosis and reason for the request; you can also send your reports. The outpatient clinic is open Monday to Friday, 08:00–16:00. No diagnosis or treatment recommendation is given via WhatsApp; the assessment takes place in person at the clinic. Consultations are held in Turkish.
Appointment
Evaluation and second opinion
If you have been diagnosed with sarcoma or would like a second opinion on your current treatment plan, you can contact Assoc. Prof. Dr. Ali Oğul with your pathology report and imaging results.
This content is for information only; please consult your physician for diagnosis and treatment.
References
- ESMO-EURACAN-GENTURIS Guidelines – Soft tissue and visceral sarcomas. Accessed: October 2026. https://www.esmo.org/guidelines/guidelines-by-topic/sarcoma-and-gist
- ESMO-EURACAN-GENTURIS-ERN PaedCan Guidelines – Bone sarcomas. Accessed: October 2026. https://www.esmo.org/guidelines/guidelines-by-topic/sarcoma-and-gist
- NCI – Soft Tissue Sarcoma / Bone Cancer (PDQ). Accessed: October 2026. https://www.cancer.gov/types/soft-tissue-sarcoma
- NCCN Guidelines – Soft Tissue Sarcoma; Bone Cancer. Accessed: October 2026. https://www.nccn.org/guidelines/category_1
- WHO Classification of Tumours – Soft Tissue and Bone. Accessed: October 2026. https://tumourclassification.iarc.who.int/
Links open external sources. The references were accessible as of October 2026.