Research Article
Diagnostic Differences in Expert Second-Opinion Consultation Cases at a Tertiary Sarcoma Center
Table 1
Summary of second-opinion cases received according to assigned referral and second-opinion lineage/differentiation.
| Tumor categories with second-opinion diagnoses | Total no. of cases | No discrepancy in opinion | Discrepancy in opinion | % with discrepancy |
| Specific lineage assignable | | | | | Fibroblastic/myofibroblastic | 99 | 65 | 34 | 34% | Adipocytic | 74 | 42 | 32 | 43% | Smooth muscle | 35 | 25 | 10 | 28% | Vascular | 32 | 22 | 10 | 31% | Nerve sheath | 32 | 21 | 11 | 34% | Skeletal muscle | 14 | 12 | 2 | 14% | So-called “fibrohistiocytic” | 25 | 9 | 16 | 64% | Pericytic | 3 | 1 | 2 | 67% |
| Lesions of uncertain differentiation | | | | | Synovial sarcoma | 9 | 6 | 3 | 33% | Atypical fibroxanthoma | 7 | 5 | 2 | 28% | Pleomorphic hyalinizing angiectatic tumor | 2 | 2 | 0 | — | Myoepithelial tumors | 9 | 6 | 3 | 33% | Ossifying fibromyxoid tumor | 4 | 3 | 1 | 25% | Angiomatoid fibrous histiocytoma | 1 | 0 | 1 | 100% | Intramuscular myxoma | 1 | 0 | 1 | 100% | Acral fibromyxoma | 1 | 0 | 1 | 100% | Epithelioid sarcoma | 3 | 1 | 2 | 67% | Undifferentiated pleomorphic sarcoma | 31 | 16 | 15 | 48% | Spindle cell sarcoma (including postradiation sarcoma) | 27 | 13 | 14 | 52% | Undifferentiated round cell tumor | 9 | 5 | 4 | 44% | Undifferentiated malignant neoplasm | 22 | 16 | 6 | 27% | Bone and cartilage tumors/lesions | 7 | 4 | 3 | 43% |
| Others | | | | | Follicular dendritic sarcoma | 2 | 2 | 0 | — | Phyllodes tumor | 3 | 3 | 0 | — | Gastrointestinal stromal tumor | 9 | 5 | 4 | 44% | Specialised genital stromal tumors | 12 | 4 | 8 | 66% | Olfactory neuroblastoma | 2 | 2 | 0 | — | Ewing sarcoma | 3 | 3 | 0 | — | Melanoma, including clear cell sarcoma | 20 | 11 | 9 | 45% | PEComa, including lymphangioleiomyomatosis | 3 | 3 | 0 | — | Meningioma | 1 | 0 | 1 | 100% | Mesothelioma | 14 | 7 | 7 | 50% | Carcinoma | 33 | 18 | 15 | 45% | Germ cell/sex-cord stromal tumors | 8 | 6 | 2 | 25% | Miscellaneous benign lesions | 24 = 134 | 22 = 86 | 2 = 48 | 8% | Total cases | 581 | 360 | 221 | 38% |
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