MEDICUS MARCH 2016

C L I N I C A L E D G E

pitfalls. An illustrative example is the EWSR1-ATF1 fusion, which can be seen in clear cell sarcoma, angiomatoid fibrous histiocytoma and clear cell hyalinising carcinoma of salivary glands. These are entities which differ strikingly in their nosological classification, biological behaviour and treatment and which can only be reliably distinguished histologically. Some of these ancillary studies require tissue to be adequately divided and preserved in special media other than formalin and therefore, biopsies are best submitted to the laboratory fresh where they can be triaged by a Pathologist, based on the suspected diagnosis on clinical and radiological grounds and sometimes on imprint smears (assuming the sample can be transported to the laboratory in a timely manner). As from 2014, the state-wide Sarcoma Service in Western Australia has been centralised at Sir Charles Gairdner and Princess Margaret hospitals offering rapid access clinics at both sites. Early referrals should be considered (prior to biopsy for the reasons indicated above) Soft Tissue Tumours A Pathologist’s Perspective Continued from page 39

Figure 1: Accurate and timely diagnosis of soft tissue tumours is best achieved in the context of a sarcoma multidisciplinary team taking into consideration the clinical, imaging and pathological features of the lesion.

Figure 2: Final diagnosis in soft tissue tumours often integrates the histological findings with the results of ancillary studies such as fluorescence in-situ hybridisation (FISH) which can assess for the presence of gene alterations.

Figure 3: Despite the present attention given to modern molecular techniques, histological assessment remains the cornerstone of diagnosis.

for patients with a soft tissue mass which is greater than 5cm or increasing in size, deep seated (deep to fascia or intramuscular), painful or multiple.

Prompt diagnosis and multidisciplinary management are key to improving the likelihood of limb salvage and optimal functional outcomes. ■

“We offer a world-leading service in implantable hearing devices and our pa benefit the most.” Professor Mar

rector speaking at the 13th Int Conference on Cochlear Implants and Other Implantable Auditory Technologies, Munich Germany.

As a part of the Ear Science Ins te Australia, a comprehensive centre of excellence for hearing health, we’re able to bring the best of research and experience into our clinic. What’s more, we have the resources and top-level skills to provide y ssessments and ongoing post-implant

There’s one outcome that each referring GP and ENT specialist demands: The best possible results for the , regardless of their age, the complexity of their c the severity of their hearing loss. The team at Ear Science Clinic has a track record in delivering the best outcomes f

Phone Email

1300 847 080

info@earscience .org.au earscienceclinic.org.au

Web

rehabilit

toring, for life.

Formerly the Hearing Implant Centre

M A R C H 2 0 1 6 M E D I C U S 41