Diagnosis
Soft tissue sarcoma is diagnosed using imaging tests and procedures called biopsies.
Imaging tests
Imaging tests create pictures of the inside of the body. They can show the size and location of a tumor. They also can show whether a tumor affects nearby tissues and organs and whether cancer may have spread. The tests you have depend on where the tumor is located.
- Computerized tomography (CT) scan. CT may be used to look at tumors in the belly, the organs in the belly and the area behind the organs. CT of the chest may be used to look for cancer that has spread to the lungs.
- Magnetic resonance imaging (MRI). MRI can look at soft tissue tumors in the arms, legs, trunk, head and neck. It can show the tumor and nearby muscles, organs and tissues.
- Positron emission tomography (PET) scan. PET scans usually are not used for the initial diagnosis of soft tissue sarcoma, but they might be used to see whether the cancer has spread or returned. This is called a cancer recurrence.
- X-rays. An X-ray may show whether a tumor starts in bone. A chest X-ray may be done to see whether cancer has spread to the lungs.
Biopsy
A procedure to remove some cells for testing is called a biopsy. A biopsy for soft tissue sarcoma needs to be done in a way that won't cause issues for future surgery. For this reason, it's a good idea to seek care at a medical center that sees many people with this type of cancer. Experienced healthcare teams can select the best type of biopsy.
Types of biopsy procedures for soft tissue sarcoma include:
- Core needle biopsy. This method uses a needle to remove tissue samples from the cancer. Healthcare professionals usually try to take samples from several parts of the cancer.
- Surgical biopsy. Sometimes, your healthcare professional might suggest surgery to get a larger sample of tissue. You may need a surgical biopsy if a tumor is located in an area in which it's hard to safely do a needle biopsy. You also may have a surgical biopsy if core needle biopsy results are not clear.
The biopsy should be looked at in a lab by a type of doctor called a pathologist who has experience diagnosing sarcomas. The pathologist looks at the tissue under a microscope to see whether the cells are cancerous. Other tests in the lab show more details about the cancer cells, such as what type of sarcoma cells they are. Understanding the type of sarcoma is important because it can affect treatment decisions.
Grades
Grade describes what the cancer cells of a soft tissue sarcoma look like under a microscope and how likely the cancer is to grow and spread. This shows how aggressive a tumor is and is part of deciding the stage of the cancer. A pathologist decides the grade by looking at:
- How different the cancer cells look from healthy cells.
- How quickly cancer cells are dividing.
- How much dead tissue called necrosis is in the tumor.
Soft tissue sarcoma grades include the following.
- Grade 1. Low grade. The cancer tends to grow and spread more slowly.
- Grade 2. Intermediate grade.
- Grade 3. High grade. The cancer is more likely to grow and spread.
Not every type of soft tissue sarcoma is graded. This is because a grade does not help predict how aggressive some types of soft tissue sarcoma may be. Examples include angiosarcoma, epithelioid sarcoma and clear cell sarcoma.
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Treatment
Soft tissue sarcoma treatment depends on the type of sarcoma, where it started, its grade and stage, and whether it has spread. The goal of treatment also varies.
For a sarcoma that has not spread, treatment may aim to remove all the cancer with surgery or destroy cancer cells with treatments such as radiation therapy. Sometimes, medicines such as chemotherapy also may be part of treatment.
When a sarcoma cannot be completely removed or has spread to other parts of the body, treatment may focus on using medicines to control the cancer and slow its growth. Treatment also may be used to relieve pain or other symptoms caused by the cancer, which is called palliative care.
Surgery
Surgery is a common treatment for soft tissue sarcoma. The goal is to remove all the cancer. During surgery, the surgeon usually removes the cancer and some healthy tissue around it.
Soft tissue sarcoma often affects the arms and legs. In the past, surgery to remove an arm or a leg was common. Today, other approaches, such as radiation and chemotherapy, usually are used to shrink the cancer. That way the cancer can be taken out without needing to remove the entire limb.
Radiation therapy
Radiation therapy treats cancer with powerful energy beams. The energy can come from X-rays, protons and other sources.
Radiation therapy may be used before, during or after surgery.
- Before surgery. For many soft tissue sarcomas, radiation before surgery may make the cancer easier to remove. Radiation before surgery also can be done on a smaller treatment area and at a lower dose. This may reduce some long-term side effects. However, radiation before surgery can affect the healing process after surgery.
- During surgery. Radiation during surgery allows radiation to be used directly on the area being treated. This limits the effects on some nearby healthy tissues.
- After surgery. Radiation may be used after surgery when there is a higher risk that the surgeon may not have been able to remove all of the cancer cells. This can happen if the cancer is located in an area that makes it difficult to remove much surrounding tissue. Radiation also may be used after surgery when it couldn't be given before surgery, such as when there's a concern about its effects on wound healing.
Chemotherapy
Chemotherapy treats cancer with strong medicines. Healthcare professionals might use chemotherapy before or after surgery. This therapy also can help treat soft tissue sarcoma that's spread to other parts of the body.
Targeted therapy
Targeted therapy uses medicines that attack specific chemicals in cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.
Your cancer cells might be tested to see whether targeted therapy could be helpful. Targeted therapy can treat certain types of soft tissue sarcoma. It also may treat cancer that comes back or spreads.
Immunotherapy and cell therapy
Immunotherapy uses medicine that helps the body's immune system find and destroy cancer cells. Tumor testing may help show whether immunotherapy could be an option. Immunotherapy may be used for soft tissue sarcoma that's spread to other parts of the body.
Cell therapy also uses the immune system to fight cancer. One type is used to treat advanced synovial sarcoma sometimes. The treatment removes T cells from your blood and changes them in a lab so they can find cancer cells. The T cells are then put back in your body.
Ablation therapy
Ablation is a procedure that applies treatment directly to cancer cells to harm them. Some types of ablation use heat, such as radiofrequency ablation or microwave ablation. Cryoablation uses extreme cold to harm the cancer cells.
Ablation may be an option when surgery isn't possible. It also might be used for some sarcomas that have spread to other parts of the body.
Palliative care
Palliative care focuses on easing symptoms and improving quality of life at any stage of cancer.
For advanced soft tissue sarcoma, you may have surgery, radiation therapy or medicines to ease symptoms even when the cancer can't be fully removed or destroyed. You can receive palliative care along with treatments intended to control the cancer.
Treatment side effects
Cancer treatment can cause side effects and complications. Surgery may affect movement and how the body works. Some people need rehabilitation after treatment. Radiation therapy can make it harder for wounds to heal. Over time, radiation can cause scarring, swelling called lymphedema and joint stiffness.
Chemotherapy and other medicines can cause different side effects depending on the drugs you get. Your healthcare team can explain the short- and long-term effects that are most likely with your treatment plan.
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Clinical trials
Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.
Coping and support
A diagnosis of cancer can feel overwhelming. With time, you'll find ways to cope with the distress and uncertainty of cancer. Until then, you may find it helps to:
- Learn enough about sarcoma to make decisions about your care. Ask your healthcare team about your soft tissue sarcoma. Discuss your treatment options. If you want to, ask about your prognosis. As you learn more, you may become more confident in making treatment decisions.
- Find someone to talk with. Find a good listener who is willing to hear you talk about your hopes and worries. This may be a friend or family member. Meeting with a counselor, medical social worker, clergy member or cancer support group also may be helpful.
- Seek support in others. If you have close friends, family or community members, those relationships may help you deal with soft tissue sarcoma. Trusted others can provide support, including taking care of your home if you're in the hospital. They can give emotional support when you feel overwhelmed by cancer.
Preparing for your appointment
Make an appointment with your usual doctor or other healthcare professional if you have any symptoms that worry you. If your care team thinks you might have soft tissue sarcoma, you'll likely be referred to a cancer doctor, called an oncologist. Soft tissue sarcoma is rare and is best treated by someone who has experience with it. Oncologists with this kind of experience are often found within an academic or specialized cancer center.
What you can do
- Write down any symptoms you have. This includes any symptoms that may seem separate from the reason for which you scheduled the appointment.
- Make a list of all medicines, vitamins and supplements that you're taking.
- Ask a family member or friend to come with you. Sometimes it can be hard to remember all the information given to you during an appointment. Someone who comes with you may remember something that you missed or forgot.
- Write down questions to ask your healthcare team.
Preparing a list of questions can help you make the most of your appointment time. List your questions from most important to least important in case time runs out. For soft tissue sarcoma, some basic questions to ask include:
- Do I have cancer?
- Are there other possible causes for my symptoms?
- What kinds of tests do I need?
- What type of sarcoma do I have?
- What stage is it?
- What treatments are available, and which do you recommend?
- What types of side effects can I expect from treatment?
- Are there clinical trials available?
- I have other health conditions. How can I best manage these conditions together?
- What's my prognosis? Ask this only if you want to know. Not everyone does.
- Are there any brochures or other printed material that I can take with me? What websites do you recommend?
- Are there other specialists that I should meet with for my cancer?
What to expect from your doctor
Be prepared to answer some basic questions about your symptoms and your health. Questions might include:
- When did you first notice your symptoms?
- Do you have pain?
- Does anything seem to make your symptoms better?
- What, if anything, appears to worsen your symptoms?
- Do you have any family history of cancer? If so, do you know what type of cancer?
Sept. 11, 2026