Diagnostic Differences in Expert Second-Opinion Consultation Cases at a Tertiary Sarcoma Center
Author:
Affiliation:
1. Sarcoma Unit, Royal Marsden Hospital, London SW3 6JJ, UK
2. The Institute of Cancer Research, London SW3 6JB, UK
Abstract
Soft tissue tumors are diagnostically challenging, and it is recommended that these are reported or reviewed by specialist soft tissue pathologists. We present our experience with second-opinion (consultation) cases in a specialist tertiary sarcoma center. The aim of this study was to determine areas of diagnostic difficulty in soft tissue pathology. We assessed 581 second-opinion cases which were reviewed by two experienced pathologists in a period of one year. There was 62% concordance between the original and the second-opinion diagnosis, with diagnostic discrepancy in 38%. The largest group of soft tissue neoplasms received for second opinion was fibroblastic/myofibroblastic tumors, and most major diagnostic problems were encountered in adipocytic and so-called “fibrohistiocytic” tumors. Major diagnostic errors impacting management were found in 148 cases (25%). Morphologic assessment of tumors, judicious use of molecular techniques, newer immunostains and their interpretation, along with importance of knowledge of rarer entities were found to be most useful in avoiding errors.
Publisher
Hindawi Limited
Subject
Radiology, Nuclear Medicine and imaging,Oncology
Link
http://downloads.hindawi.com/journals/sarcoma/2020/9810170.pdf
Reference20 articles.
1. Histopathological Diagnostic Discrepancies in Soft Tissue Tumours Referred to a Specialist Centre
2. Histopathological Diagnostic Discrepancies in Soft Tissue Tumours Referred to a Specialist Centre: Reassessment in the Era of Ancillary Molecular Diagnosis
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