What clinical features should raise suspicion for soft tissue sarcoma in a patient presenting with a soft tissue mass?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

For a patient presenting with a soft tissue mass, the primary clinical feature that should raise suspicion for soft tissue sarcoma is an unexplained lump that is increasing in size .

  • In adults, an unexplained lump that is increasing in size should prompt consideration of an urgent, direct access ultrasound scan to be done within 2 weeks .
  • In children and young people, an unexplained lump that is increasing in size should lead to consideration of a very urgent, direct access ultrasound scan to be done within 48 hours .

If ultrasound scan findings are suggestive of soft tissue sarcoma, or if findings are uncertain and clinical concern persists, further referral is indicated . For adults, this would be a suspected cancer pathway referral . For children and young people, a very urgent referral for specialist assessment within 48 hours should be considered .

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