Reviewed on : 12 Nov 2025

Reviewed by : Poppy Roberts

Expires : 12 Nov 2027

ORTHOPAEDICS / SARCOMA 2WW

Sarcomas & Primary bone tumours – Indications for an urgent referral for a suspected new malignancy

All suspected sarcomas should be referred to our local teams at UHCW or SWFT to allow appropriate imaging and onward referral

A suspicious mass meeting the NICE NG12 urgent suspected cancer sarcoma criteria (listed below), or a radiology report suggesting a possible sarcoma and recommending further imaging, should be referred directly to UHCW or SWFT for the team to investigate

If the diagnosis is confirmed, an appropriate referral into the tertiary centre can be made

• Do not refer directly to the regional sarcoma centres at ROH or UHB
• Spinal lesions need to be directed to UHCW only
• Please be aware patient with confirmed asymptomatic lipomas will not be offered surgical removal, as per the aesthetic policy.
• If an intra-abdominal or pelvic organ sarcoma is found in primary care please refer to the appropriate internal organ teams, e.g. colorectal or gynaecology

Sarcomas & Primary bone tumours – Indications for an urgent referral for a suspected new malignancy

Soft tissue mass with one or more of the following characteristics:

• Size > 5 cms
• Painful
• Increasing in size
• Deep to fascia
• Recurrence after previous excision
• Recent change in pre existing lump or swelling
• Radiological suspicion of a primary bone tumour (based on evidence of bone destruction, new bone formation, soft tissue swelling and periosteal elevation).
• Ultrasound suspicion of soft tissue sarcoma
• Ultrasound uncertain of soft tissue sarcoma and clinical concern persists

Issue the patient with a Cancer Research UK Information Sheet – follow link

Two Week Wait referrals should now be processed through the NHS eReferral Service (previously known as Choose & Book)