Subcutaneous tissue malignancies and masses Referral Access Criteria

Referrers should use this page when referring patients to public adult plastics and reconstruction surgery outpatient services for subcutaneous tissue malignancies and masses.

Emergency referral
If any of the following are present or suspected, refer the patient to the emergency department or seek emergency medical advice if in a remote region.
Uncontrolled bleeding Abscess or haematoma within the neck Suspected necrotising fasciitis Upper limb cellulitis with suspicion of sepsis or septic shock

Immediate referral
Immediately contact the on-call registrar or service to arrange an immediate plastics and reconstructive surgery assessment (seen within 7 days):
Infected cysts around critical areas (e.g. eyes, lips) Clinically large fungating lesion or exophytic tumours with delayed presentation to healthcare

Clinical indications for outpatient referral
If any of these issues are present, refer to outpatient services through the Central Referral Service (CRS).
Suspected malignancy Malignant subcutaneous masses Recurrent benign subcutaneous masses (e.g. lipomas, cysts) Parotid masses present for ≥4 weeks Deep masses present ≥4 weeks Symptomatic (repeatedly infected, causing pain) sebaceous cysts present for ≥4 weeks Masses near vital structures requiring specialist removal

Mandatory information
History	Relevant history, onset, duration of symptoms including pain, rapid growth, neurological symptoms, or presence of lymph nodes Current medication list Any known allergies
Examination	Nil
Investigations	Ultrasound (US) or CT

Highly desirable
History	Details of smoking and/or vaping (containing nicotine) status Advise whether or not your patient is taking any anti-platelets or anti-coagulants if so, state the indication
Examination	BMI
Investigations	FBC LFT ESR Coags CT chest +/- FNA (not for suspected sarcoma)

Indicative clinical urgency category
Category 1 Appointment within 30 days	Suspected malignancy Recurrent malignant or suspected malignant subcutaneous masses (e.g. sarcomas) Masses near vital structures requiring specialist removal
Category 2 Appointment within 90 days	Parotid masses persisting for ≥4 weeks Deep masses persisting for ≥4 weeks Recurrent benign subcutaneous masses (e.g. lipomas, cysts)
Category 3 Appointment within 365 days	Symptomatic (repeatedly infected, causing pain) sebaceous cyst persisting for ≥4 weeks

Indicative clinical urgency category

Category 1

Appointment within 30 days

Suspected malignancy
Recurrent malignant or suspected malignant subcutaneous masses (e.g. sarcomas)
Masses near vital structures requiring specialist removal

Category 2

Appointment within 90 days

Parotid masses persisting for ≥4 weeks
Deep masses persisting for ≥4 weeks
Recurrent benign subcutaneous masses (e.g. lipomas, cysts)

Category 3

Appointment within 365 days

Symptomatic (repeatedly infected, causing pain) sebaceous cyst persisting for ≥4 weeks

Exclusions
Burns refer to State Burns Service see Clinician Assist WA: Specialised Burns Management Requests Chest and abdomen soft tissue infections refer to General Surgery Lower limb soft tissue infections without ulceration, including cellulitis of the lower limb refer to General Medicine, Infectious Diseases and/or Silver Chain Hospital at the Home see Clinician Assist WA: Cellulitis in Adults Ganglion not on the wrist/hand AND causing compressive nerve symptoms, pain, or functional disability refer to following specialties Orthopaedics General Surgery

Useful information
Parotid masses can be referred to any of the following specialties and will be triaged in line with local agreements: Plastic and Reconstructive Surgery ENT General Surgery Oral and Maxillofacial Surgery

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Last reviewed: 15-08-2025

Subcutaneous tissue malignancies and masses Referral Access Criteria

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