Soft Tissue Tumor and Sarcoma Surgery in Delhi

About Soft Tissue Tumor and Sarcoma Surgery in Delhi

Soft tissue sarcomas are rare cancers that arise from muscle, fat, fibrous tissue, vessels, and nerves. Many lumps are benign (lipoma, schwannoma, ganglion, TGCT), but a subset are malignant and need precise planning. Success depends on correct sequence: proper imaging, a planned biopsy with a tract that can be excised, margin‑appropriate surgery, and coordinated adjuvant therapy. Function‑preserving strategies—careful compartment planning, neurovascular protection, and thoughtful reconstruction—support limb use and quality of life.

As Orthopedic Surgeons, we lead level‑headed decision‑making: when to watch, when to excise a benign tumor, and when to execute a full sarcoma pathway. We work with radiology, pathology, radiation oncology, and medical oncology to align the plan with tumor biology, location, and your goals.

Evaluation & Staging

• MRI with contrast: Defines size, depth, compartment, and relation to fascia, bone, and neurovascular bundles.
• Chest imaging: CT chest for lung metastasis screening; consider PET‑CT in select subtypes or if metastatic disease is suspected.
• Core needle/incisional biopsy: For grade and subtype with immunohistochemistry (IHC); FNCLCC grading guides adjuvant therapy.
• AJCC staging: Incorporates size, depth, grade, and metastasis to risk‑stratify care.
• Baseline labs: CBC, renal/liver profile; additional tests per comorbidities before anesthesia.

Staging aligns surgery, radiation, and systemic therapy to maximize control and function.

Multidisciplinary Treatment Plan

Management is coordinated with radiology, pathology, radiation oncology, and medical oncology. For high‑grade, deep tumors, radiation is often combined with surgery; certain subtypes may benefit from chemotherapy. Benign and intermediate tumors (e.g., atypical lipomatous tumor, desmoid‑type fibromatosis, schwannoma) may be observed or excised based on symptoms and growth.

• Pre‑op radiation: May reduce field size and late fibrosis; higher wound‑complication risk that we mitigate with coverage planning.
• Post‑op radiation: When margins are close/positive or for high‑risk features.
• Chemotherapy: Subtype‑specific benefit (e.g., synovial sarcoma, certain pediatric‑type sarcomas); medical oncology leads regimens.

The sequence is individualized to tumor biology and location while protecting function.

Limb‑Sparing & Reconstruction

Most patients can avoid amputation with modern imaging, radiation, and surgical techniques. After wide excision, we restore durable coverage and function with flaps, grafts, and targeted repairs to enable early rehabilitation and, if needed, adjuvant radiation.

• Soft‑tissue coverage: Local/regional flaps or skin grafts planned to tolerate radiation and reduce wound breakdown.
• Tendon/nerve work: Tendon transfers and nerve grafts in select cases to preserve hand/foot function.
• Vascular reconstruction: Bypass or interposition grafts where vessel resection is required.
• When amputation is wiser: If salvage threatens survival or durable function, a planned amputation with prosthetic optimization is discussed transparently.

The aim is oncologic control and a limb you can trust.

Anesthesia & Pain Strategy

We tailor anesthesia to the procedure and your medical profile. Regional blocks and multimodal, opioid‑sparing strategies improve early mobility and sleep. Clear, written dosing schedules reduce confusion at home.

• Regional + GA as needed: Improves immediate pain control and may reduce opioid use.
• Simple schedules: Paracetamol ± anti‑inflammatories when appropriate; neuropathic pain agents selectively for nerve resections.
• Medical optimization: Glycemic control, nutrition support, and DVT prophylaxis risk‑stratified.