Soft tissue sarcoma in the retroperitoneum:an often neglected diagnosis

Aims: Successful surgical treatment of patients with retroperitoneal soft tissue sarcoma (RSTS) is based on preoperative planning that starts with a correct pre-operative diagnosis. In a population-based study, we determined which patients were initially treated for assumed other conditions. The effect of an erroneous diagnosis on the installed treatment was analysed.Method: With the help of the Dutch Network and National Database for Pathology (PALGA), data were collected on 143 patients in the Netherlands in whom a primary RSTS was found and confirmed histologically between I January 1989 and 1 January 1994. Satisfactory clinical information was obtained on 138 patients, 64 males and 74 females (54%). The median age was 60 (range 18-88) years.Results: At the time of actual treatment 37% of the patients with RSTS were assumed to have another disorder (group I; n=51), whereas 87 patients were diagnosed as having RSTS (group 2). In group I, an acute presentation was more common (18 vs 2%; P=0.002), and the tumour was less often palpable at physical examination (43 vs 69%; P=0.004), while clinical work-up less frequently included CT-imaging (57 vs 89%; PConclusions: (1) More than one-third of patients with RSTS are misdiagnosed and inappropriately treated; and (2) biopsies and cross-sectional imaging improve diagnosis. (C) 2001 Harcourt Publishers Ltd.