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Soft tissue sarcomas are a heterogeneous group. Because of their rarity, they frequently pose diagnostic problems for surgical pathologists. Accurate diagnosis of these tumors is enhanced by knowledge of the clinical features of the given lesions and, at times, by application of immunohistochemical and molecular techniques. In this chapter, the lesions are described essentially in accordance with the World Health Organization (WHO) classification.1 It is beyond the scope of this chapter to cover all described soft tissue entities; both expanded2 and concise3 textbooks are also available.

Grading and Staging

Grading soft tissue tumors applies only to sarcomas. Histologic grade is an important (if not the most important) prognostic parameter in soft tissue neoplasia.4 Therefore, general grading schemes have been devised and studied over the past several decades in that correlate with prognosis, recurrence, metastasis free, and overall survival4,5 but the French Federation of Cancer Centers system, that uses differentiation, mitosis, and necrosis in their grading system provides the best prognostic information6,7 (Table 25-1) and is the preferred one for the AJCC staging systems as of 2010.8

TABLE 25-1

French Federation of Cancer Centers (FNCLCC, Fédération Nationale des Centres de Lutte Contre le Cancer) Grading Systema

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