Histomorphological Spectrum of Soft Tissue Tumors at a Tertiary Care Hospital

Background Soft tissue tumors (STT) comprise a broad and heterogeneous group of mesenchymal neoplasms with varied histological patterns and biological behavior. Accurate histomorphological evaluation and grading are essential for appropriate diagnosis, prognostication, and management, particularly in malignant cases. Objectives The present study was undertaken to analyze the histomorphological spectrum of soft tissue tumors encountered at a tertiary care hospital, to classify them according to the World Health Organization (WHO) 2022 classification, and to grade malignant tumors using the Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grading system. Methods This combined retrospective and prospective descriptive study included 125 cases of soft tissue tumors received in the department of pathology of a tertiary care center over a one-year period. Clinical details were retrieved from requisition forms. Histopathological examination was performed on hematoxylin and eosin-stained sections, and tumors were classified based on WHO criteria. FNCLCC grading was applied to all malignant tumors. Immunohistochemistry (IHC) was performed wherever feasible to support diagnosis. Results Out of 125 cases, benign tumors constituted the majority at 107 cases (85.6%), followed by malignant tumors at 15 cases (12.0%) and intermediate tumors at three cases (2.4%). Patients ranged in age from five to 78 years, with a mean age of 39.6 ± 16.8 years. A slight male predominance was observed. Adipocytic tumors were the most common histological subtype, followed by fibroblastic and myofibroblastic tumors. Among malignant tumors, fibrosarcoma was the most frequent subtype. FNCLCC Grade 3 sarcomas were most common, indicating a predominance of high-grade malignancies. Conclusion Benign soft tissue tumors were far more common than malignant and intermediate tumors in the present study. Adipocytic tumors formed the largest histological category, while high-grade sarcomas predominated among malignant cases. Detailed histomorphological evaluation, supported by FNCLCC grading, remains crucial for the accurate classification and prognostic assessment of soft tissue tumors.