Introduction
Sarcomas belong to a heterogenic group of mesenchymal tumors affecting soft tissues (common) or bones (rare lesions). Diagnosing sarcomas is often difficult
due to the general rarity of this tumor group compared to epithelial of hematologic tumors on one hand, and to the large number of entities with partially
overlapping histopathologic properties on the other. Recent years led to a deeper understanding of the complex genetic background of mesenchymal neoplasia and
widening of the spectrum of diagnostic pathologic tools allowing better definitions and identification of individual tumor subtypes.
In 2020, the WHO Classification of Soft Tissue and Bone Tumors was published and lists over 100 tumor entities including variants, often characterized by specific
genetic aberrations, which can be detected by molecular diagnostic studies.
Establishing the precise tissue diagnosis of a soft tissue or bone tumor is paramount for the choice of the correct individual treatment strategy for every
patient. Experienced pathologists, who are involved in sarcoma diagnostics on a daily basis and who have access to auxiliary studies, must perform the
histological diagnostics of sarcomas.
It is well documented that an incorrect histopathological diagnosis may lead to the initiation of false therapy with severe deleterious consequences for the
patient. Due to the rarity of soft tissue and bone tumors and difficulties in their understanding and diagnostics, the discrepancies in initial histopathologic
diagnosis may differ in up to one third of the cases. A mandatory systematic review of all diagnoses by the reference pathology as well as regular correlation of
the histopathologic findings with the clinical situation and imaging during the multidisciplinary tumor boards ensure the correctness of the histopathological
diagnostics.
Requests for a second opinion of biopsy samples of soft tissue and bone tumors:
- Contact:
- Submission of all histological slides and at least one representative paraffin block
- Comprehensive documentation including original histology reports
Pathology review SSN
Prof. Beata Bode-Lesniewska, an experienced pathologist with many years of expertise in histopathology of mesenchymal neoplasia, in collaboration with the
Working Group on Sarcoma (WGS) of the Swiss Association of Pathology (SSPath), coordinates the reference pathology review of biopsy material of patients
referred to the SwissSarcomaNetwork.
Current biopsy material of all patients listed for the sarcomaboard is either directly diagnosed or reviewed by the reference pathologist. The histopathological
results of individual patients are presented at the weekly sarcomaboard. The concurrent referral of the patient for the discussion at the sarcomaboard and
initiation of the reference review of histopathological diagnoses at the same time ensure the quality of the pathological diagnoses and prevent delays in decision
making regarding treatment.
The WGS group of the Swiss Association of Pathology (SSPath) reviews and analyzes the quality of the histopathological diagnoses of the SSN patients biannually.
Working group on sarcomas
The Swiss Association of Pathology (SSPath) organizes several working groups related to various topics of pathological diagnostics. Regarding sarcoma, there
is a soft tissue and bone working group. Working Group on Sarcoma (WGS) of the SSPath is an active group of pathologists from different Swiss institutes, who are interested in
soft tissue mesenchymal neoplasia. Prof. Beata Bode-Lesniewska organizes the WGS meetings since 2003.
The WGS discusses the new developments in mesenchymal tumors based on interesting case examples submitted by its members. The histopathological diagnoses of the sarcomas of the SSN patients are reviewed retrospectively.