FIGURE 6.

Flowchart of diagnosis of soft-part tumours based on ultrasound scoring. This flowchart proposes a screening procedure for soft-part tumours (SPTs). The screening procedure is mainly based on stratification by the ultrasound-based sarcoma screening (USS) score. The USS score is evaluated at the initial visit (0–6 points). If the score is low (0–2 points), the patient can be observed periodically over several months. If the score increases or the tumour size rapidly increases on the second visit or later, the physician may consider performing MRI (*). If the score is high at the initial visit (3–6 points), MRI may be recommended. In this group, peripheral nerve sheath tumours and vascular tumours may be diagnosed based on characteristic clinical symptoms without MRI. MRI can usually be used to diagnose typical fibrous tumours, lipomas, and pigmented villonodular synovitis (PVS) / giant cell tumour of the tendon sheath (GCT-TS). When malignant SPT is suspected, biopsy should be performed to obtain a pathological diagnosis.

UPS = Undifferentiated pleomorphic sarcoma;

WDL = Well-differentiated liposarcoma