Department 08 · Sarcoma & Bone Tumours

Where the first surgery matters most.

Soft-tissue and bone sarcomas behave differently from common cancers — they seed along tissue planes. The difference between a cure and a recurrence is frequently decided in operating theatre number one.

Limb salvage the default aim Wide margins planned, not guessed No “whoops” surgeries here GIST managed on protocol
Understanding

What are sarcomas?

Sarcomas are rare — and rarity breeds casual handling: a lump shelled out somewhere without imaging, a pathology report that surprises everyone, a second operation starting from a worse position than the first one faced.

The discipline of this department is wide, compartment-aware excision — removing tumour with a collar of healthy tissue along lines planned on MRI, so the scalpel never plays catch-up.

Bone sarcomas are fought alongside orthopaedic oncology colleagues; desmoids and GIST follow their own rulebooks, honoured accordingly. And when a lump was already removed elsewhere, re-excision is approached without blame and without shortcuts.

Before any lump surgery anywhere: has sarcoma been ruled out? One question, asked early, saves limbs.

Listen to your body

Eight signs a lump deserves respect

Most lumps are innocent. These are the features that separate the ones worth imaging before touching.

  • A lump growing steadily, week over week.
  • Any deep lump larger than five centimetres — roughly two inches.
  • A lump that hurts.
  • A lump that returned after previous removal.
  • Limb swelling without any injury.
  • A lump sitting deep or fixed, not just skin-deep.
  • A previously removed “fatty lump” whose pathology was never tested.
  • Scheduled for a lump excision anywhere — a pre-operative second opinion is cheap insurance.
Scope of care

Conditions this department treats

Limb Soft-Tissue Sarcoma

Wide, compartment-aware excision with limb salvage as the aim.

Trunk & Retroperitoneal Sarcoma

Multivisceral resection when tissue planes demand it.

Osteosarcoma

With orthopaedic oncology; chemotherapy-first protocols honoured.

Ewing Sarcoma

Combined-modality pathways, coordinated centrally.

Desmoid Tumours

Watching, medication or surgery — weighed honestly case by case.

GIST

Targeted-therapy-first logic; surgery timed to response.

Procedures

Operations performed here

  • Wide compartment-aware excisionMargins designed on MRI before the incision is drawn.
  • Limb-salvage surgeryFunction preserved; amputation now exceptional rather than customary.
  • Retroperitoneal multivisceral resectionOrgans sacrificed to margins deliberately — never accidentally.
  • Re-excision of previously “shelled out” lumpsPlanning that recovers what a first operation missed.
  • Coordinated radiotherapy & chemotherapySequenced with oncology around the operation.
  • GIST managementMutation-driven therapy first, surgery in its proper supporting role.
Your care pathway

From first visit to full recovery

  1. 10:00

    First consultation

    Imaging before needles, needles before knives — the sequence is enforced, not suggested.

  2. 08:12

    Biopsy & board

    Core biopsy taken along the future incision line; multidisciplinary staging follows.

  3. 13:26

    Margin mathematics

    What “wide” really means, drawn and explained; function trade-offs stated openly.

  4. 09:15

    Surgery

    Planned excision with reconstruction coordinated in the same anaesthetic.

  5. 06:04

    Day-one rounds

    Wound checks, pathology chased personally, mobilisation begun.

  6. 17:40

    Home & surveillance

    Local-recurrence scan schedule set, rehabilitation goals written down.

Honest answers

Families usually ask…

Because sarcomas seed along tissue planes, and a casual excision contaminates them. Getting the first operation right prevents the “whoops procedure” that costs function later.

Usually no — limb salvage succeeds in most cases when margins are planned properly. Honesty cuts both ways: when amputation is genuinely the safer course, you will hear it early, not late.

Removing tumour plus a protective cuff of healthy tissue in every direction — measured on MRI and marked before surgery. Simply shelling the lump out leaves microscopic seeds behind.

Yes, but it obeys different rules — targeted tablets often shrink it dramatically, and surgery is timed around drug response rather than rushing to the operating theatre.

Bring the pathology report and scans; we plan re-excision without drama and without blame. Most situations are recoverable — sooner is simply easier than later.

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