WHO soft tissue and bone sixth edition: what changes at sign-out

The sixth edition of the WHO Classification of Soft Tissue and Bone Tumours was summarised by its editors on 7 October 2026. It was drafted by 203 editors and authors from 27 countries and specialties beyond pathology.

It covers 116 soft tissue tumour types, 46 bone tumours, 18 vascular tumours, 4 undifferentiated spindle and round cell sarcomas, 6 haematopoietic and dendritic cell neoplasms and 6 genetic syndromes, with 62 sarcomas in all. Nineteen new entities were added. The terms have been tightened: a tumour type differs from others in several dimensions; a subtype differs in at least one and should ideally change treatment or outcome; and 'morphological pattern' replaces 'variant' for appearances worth recognising that do not change behaviour. Essential and desirable criteria have been refined with different resource settings in mind.

For reporting, this means updating templates and terminology, and checking that 'variant' no longer appears where the edition now uses 'pattern'. The resource-aware criteria are especially relevant to laboratories without ready access to molecular testing. The summary article does not list every new entity, so the full volume is needed before updating local guidance.

• Replace 'variant' with 'pattern' in reports where the appearance does not change clinical behaviour.
• Reserve 'subtype' for differences that alter treatment or prognosis.
• Review soft tissue and bone reporting templates against the new essential and desirable criteria.
• Check the full volume for the 19 new entities before revising local diagnostic algorithms.

Why it matters

Oncologists act on the label a pathologist uses, so the vocabulary change is not cosmetic.

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