Where the first surgery matters most.
With sarcomas, a casually planned “quick lump removal” can cost function, limbs or cure chances. Here the discipline runs the other way: imaging before biopsy, biopsy before excision, and wide margins planned along anatomy — because in this disease, there is rarely a second chance to do the first operation right.
What are sarcomas?
They are cancers of the body’s structural tissue: soft-tissue sarcomas arising in muscle, fat and deep connective tissue — limb, trunk or retroperitoneum (the space behind abdominal organs) — and bone sarcomas like osteosarcoma and Ewing’s, managed together with orthopaedic oncology. Desmoid tumours and GIST round out the family.
Sarcomas are rare, which matters practically: they behave differently from common cancers, respond to different drugs, and are best treated by teams who see them regularly.
The cardinal rule: any lump that is growing, deeper than the skin, larger than five centimetres, or painful — deserves imaging before anything else, including removal. Planning first is not delay; it is protection.
Signs that deserve proper imaging first
Not every lump is a sarcoma — most aren’t. But these features change how the lump should be approached from the very first step.
- ①A lump that keeps growing, however slowly.
- ②A lump deeper than the skin layer — firm and fixed rather than freely mobile.
- ③Any lump larger than five centimetres — roughly a golf ball.
- ④A lump that hurts when pressed or with use.
- ⑤A lump that has come back after previous removal.
- ⑥Swelling of an arm or leg without an injury to explain it.
- ⑦A lump already removed casually without prior imaging — this deserves specialist re-review even if it seemed fine.
- ⑧Persistent bone pain, or a fracture from a minor knock — especially in young people.
Conditions we treat
◆Limb & Trunk Soft-Tissue Sarcoma
Wide, compartment-aware excision with function kept central.
◆Retroperitoneal Sarcoma
Deep abdominal tumours requiring multivisceral, planned resection.
◆Bone Sarcomas
Osteosarcoma and Ewing’s, coordinated with orthopaedic oncology colleagues.
◆Desmoid Tumours
Locally aggressive but non-metastasising — managed with restraint as much as surgery.
◆GIST
Gastrointestinal stromal tumours — targeted therapy has changed their story entirely.
◆Re-excision & Second Opinions
Reviewing lumps removed elsewhere without proper planning.
Operations performed here
- ◆Wide compartment-aware excisionMargins planned along natural tissue planes — removing the tumour plus its invisible halo.
- ◆Limb-salvage surgeryAmputation is the exception here, not the default; limbs are saved wherever oncology safely allows.
- ◆Retroperitoneal multivisceral resectionDeep tumours removed together with involved organs, planned organ by organ beforehand.
- ◆Re-excision of shelled-out lumpsCorrecting unplanned removals with proper definitive surgery.
- ◆Coordinated radiotherapy & chemotherapySequenced around surgery where protocols call for them.
- ◆GIST managementTargeted tablets alongside surgery, matched to mutation profile.
From first visit to full recovery
MRI before anything else
The scan maps depth, planes and neighbours — planning starts here.
Biopsy along the incision line
Taken through the exact route future surgery will use, so no tissue is wasted.
Multidisciplinary plan
Orthopaedic oncology, radiation and medical opinions aligned first.
Wide excision
Margins confirmed on final pathology — the whole point of the plan.
Function rehabilitation
Physiotherapy aimed at returning strength, mobility and confidence.
Long surveillance
Sarcomas recur late; reviews continue for years, deliberately.
Families usually ask…
Because an unplanned “shelling out” of a sarcoma leaves tumour cells behind and contaminates tissue planes — turning a curable situation into one needing bigger, riskier re-excision. One pre-op consultation can prevent exactly that. If your lump was already removed, bring us the pathology; there is still a correct next step.
In most modern soft-tissue sarcoma cases, no — limb salvage succeeds in the large majority when treatment is properly planned. Bone sarcomas have more variables, but reconstruction techniques keep saving limbs that once would have been lost. Amputation remains necessary sometimes; when it is, you’ll hear it honestly, never by surprise.
Removing the tumour plus a cuff of healthy tissue all around — because microscopic cells extend invisibly beyond what you can see or feel. A narrow “just the lump” excision looks neat on the surface and leaves disease behind. Width is why the first cut must be the right one.
Yes, though it behaves unlike typical cancers — it rarely spreads to lymph nodes and responds remarkably to targeted tablet therapy. With the right drug matched to its mutation, many GISTs become long-term managed conditions rather than emergencies.
No. Bring the pathology report and scans. Many turn out benign and need nothing further. If it was a sarcoma, planned re-excision of the scar bed — done promptly and properly — still gives excellent outcomes. What’s past is past; what matters now is done right.