Distinguishing features that can aid in narrowing the diagnosis of a soft-tissue mass are the size, depth, consistency, and mobility of the mass. Typically, masses that are superficial and less than 5 cm in size tend to be benign, whereas, masses that are greater than 5 cm or found deep to the fascia have a higher likelihood of being malignant.
How is soft tissue mass diagnosed and treated?
Summary The successful evaluation and management of soft tissues masses requires a systematic approach. A thorough history and physical examination in conjunction with appropriate imaging studies are essential for an accurate diagnosis.
What are the characteristics of a soft tissue mass?
History and physical are highly variable for soft-tissue masses. Size, consistency, depth, and absence or presence of growth are all important features to consider. Masses that are small, soft, superficial, and dormant are most likely benign and may be observed.
What is the prevalence of soft tissue mass?
Soft Tissue Masses. They are common, have a prevalence of 2.1%, and account for nearly half of all soft tissue masses. 20 Frequent locations include the shoulder region and back. 20 Lipomas are often present for many years with little or no growth. Malignant transformation is nonexistent with no metastatic potential.
Which features can aid in narrowing the diagnosis of soft-tissue mass?
Physical Exam Distinguishing features that can aid in narrowing the diagnosis of a soft-tissue mass are the size, depth, consistency, and mobility of the mass.
How are soft tissue tumors diagnosed?
CT (computed tomography) scans A CT scan uses x-rays to make detailed cross-sectional images of your body. This test is often done if the doctor suspects a soft tissue sarcoma in the chest, abdomen (belly), or the retroperitoneum (the back of the abdomen).
What is a large soft tissue mass?
Soft tissue sarcoma refers to cancer that begins in the muscle, fat, fibrous tissue, blood vessels, or other supporting tissue of the body. The tumors can be found anywhere in the body but often form in the arms, legs, chest, or abdomen. Signs of soft tissue sarcoma include a lump or swelling in soft tissue.
What criteria are used to grade soft tissue sarcomas?
Three parameters are evaluated: tumour differentiation, mitotic count and tumour necrosis. The main value of grading is to predict the probability of distant metastases and overall survival (OS).
How do you diagnose a soft tissue sarcoma?
Diagnosing soft tissue sarcomasscans – an ultrasound scan is usually the first test done and is fairly simple and quick. Further scans, such as an MRI scan, may be done later.a biopsy – where a sample of suspected cancerous tissue is removed, using a needle or during an operation, so it can be analysed in a laboratory.
What is considered a large lipoma?
Lipomas are slow-growing soft tissue tumours that rarely reach a size larger than 2 cm. Lesions larger than 5 cm, so-called giant lipomas, can occur anywhere in the body but are seldom found in the upper extremities.
What percentage of soft tissue masses are malignant?
Background. Malignant soft tissue tumors account for approximately 1% of all adult and approximately 20% of all pediatric solid malignant cancers [1, 2]. The most common entities among malignant soft tissue sarcomas are liposarcoma, leiomyosarcoma, and undifferentiated pleomorphic sarcoma [3].
How big is soft tissue sarcoma?
Stage I soft tissue sarcomas are low-grade tumors of any size. Small (less than 5 cm or about 2 inches across) tumors of the arms or legs may be treated with surgery alone. The goal of surgery is to remove the tumor with some of the normal tissue around it.
What is high grade soft tissue sarcoma?
High grade: In high-grade soft tissue sarcoma, the cancer cells look more abnormal under a microscope and grow and spread more quickly than in low-grade and mid-grade soft tissue sarcoma.
What is tissue code 1A?
1a means the cancer is smaller than 5cm and has not spread to the lymph nodes or other parts of the body. The cancer cells are grade 1, or cannot be assessed.
What is tissue diagnosis?
A tissue diagnosis is the diagnosis made when a piece of tissue is examined by a pathologist, a doctor who is trained to examine tissue. He or she interprets the findings in tissue and makes a diagnosis.
How big is a sarcoma lump?
The mean size of all sarcomas at presentation was 10.7 cm and did not vary significantly between the main diagnostic categories (soft tissue sarcomas, 10 cm; osteosarcoma, 11.3 cm; chondrosarcoma, 11.7 cm; Ewing's sarcoma, 11.2 cm) whilst the range was from 0.2 cm to 45 cm.
What does soft tissue mean on a CT scan?
A CT Neck (Soft Tissue) is an exam that takes very thin slice (3.5mm) images of the neck, starting from just above the ears and ending just below the clavicles (collar bone). This allows more accurate diagnosis of conditions involving areas such as the nasal passages, mouth, throat, thyroid and parotid glands.
Where do soft tissue masses come from?
Soft tissue masses can emerge anywhere in the body, and specialists cross the spectrum of physician expertise. Orthopedic oncologists tend to perform resections from the arms and legs, pelvis, spine and occasionally the chest wall; general surgical oncologists tend to operate when tumors are located in the abdomen or pelvis. Otolaryngologists and/or neurosurgeons typically perform surgery to remove head and neck tumors. Spinal specialists often assist with spinal surgeries.
How many new soft tissue tumors are diagnosed annually in the United States?
Some 10,000 new soft tissue and bone sarcomas (cancerous growths) are diagnosed annually in the United States. Benign soft tissue tumors are discovered at a significantly higher rate than sarcomas. Soft tissue tumors affect every segment of the population.
How do soft tissue tumors grow?
A soft tissue tumor grows, slowly or quickly, in the body, based on its etiology. Generally, soft tissue tumors grow in a round orientation, though some can grow more oval or sausage-shaped. Most such growths remain within borders of fascia tissue, though they can cross such boundaries as they grow.
Why do hematomas need to be recurrence?
They merit attention because they could be cancerous. A sprain or hematoma that lasts longer than six weeks merits additional medical scrutiny for the possible presence of a soft tissue tumor. The risk of recurrence is related to the type of tumor, the adequacy of initial surgical excision, and the tumor’s location.
How long does it take for a soft tissue tumor to heal?
Such misperceptions can contribute to delayed diagnoses of soft tissue tumors – often as long as three to six months after the patient's initial discovery of a bump or lump.
What is the treatment for sarcoma?
If a sarcoma (cancerous growth) is diagnosed, doctors recommend expeditious treatment involving surgery, chemotherapy, radiation therapy or a combination thereof. For any soft tissue tumor, the surgeon's goal is to remove all of the tumor. With cancerous tumors, surgeons more aggressively remove surrounding tissue.
Why are soft tissue masses painful?
The majority of soft tissue masses are painless -- unless they are irritating a nerve nearby – and this is a primary reason why many masses are not diagnosed until they have developed significantly in size. Soft tissue masses may cause skin discoloration if blood flow increases to the region or if veins are distended, but usually skin around the mass retains its normal color.
What is the imaging modality of choice for the majority of soft tissue tumors?
MRI is the imaging modality of choice for the majority of soft-tissue tumors. When imaging is not definitive for a benign process, then needle biopsy or referral is indicated. Keywords: benign; biopsy; chemotherapy; malignant; MRI; radiation therapy; resection; sarcoma; soft tissue; staging.
What is the most common soft tissue tumor?
Lipoma. Lipoma is the most common soft-tissue tumor that will be encountered by an orthopaedic surgeon and is one of the few soft-tissue masses that can be definitively identified on imaging. On MRI, the mass simply needs to be compared to the subcutaneous fat. A lipoma will demonstrate the same imaging features as subcutaneous fat on all MRI ...
What is atypical lipoma?
When treating the larger variety of lipoma , it is important to be aware of a variant known as atypical lipoma/well-differentiated liposarcoma (ALT/ WDL). This variant can be classified as a low-grade malignancy with higher recurrence rates than typical lipomas but, when located in the extremity, rarely dedifferentiate or metastasize. For this reason, marginal resection is appropriate with the knowledge that the recurrence rate is higher than garden variety lipomas. On imaging, atypical lipomas tend to be larger, more septated, and less homogenous on MRI when compared with standard lipomas 5 ( Figure 3 ). Following resection, atypical lipomas can be identified solely by histologic features, but when equivocal, the authors of a 2016 study have identified FISH for MDM2 as the ancillary study of choice. 6
Why are popliteal cysts not homogenous?
Popliteal cysts can become quite large and are not always homogenous on MRI because of debris, loose bodies, or hemorrhage that can accumulate in the cyst. The lining of the cyst will show enhancement on contrast MRI and can be quite thickened and septated because of inflammation.
What is a meniscal cyst?
Meniscal Cyst. Meniscal cysts are the result of joint fluid accumulation outside of the knee capsule and may present as a painful, firm mass along the joint line of the knee. This collection of fluid is due to a capsular defect that acts similar to a one-way valve.
What are the different types of lipoma?
Several variants of lipoma exist: angiolipoma, fibrolipoma, spindle cell lipoma, hibernoma. Not only do these variants differ histologically from a lipoma, they also display unique chromosomal aberrations. The imaging features can also be variable when compared with a classic lipoma.
What are the characteristics of a benign mass?
Size, consistency, depth, and absence or presence of growth are all important features to consider. Masses that are small, soft, superficial, and dormant are most likely benign and may be observed. Firm, deep, and enlarging masses require a higher level of suspicion.
Where can soft tissue tumors be found?
Soft tissue masses — or tumors — are fairly common and can vary significantly depending on their location and type. They can develop nearly anywhere in your body, including within or between ligaments, muscles, blood vessels, and nerves. You can also have soft tissue masses grow around other structures in your body, such as bones, nerves, ...
Where are soft tissue sarcomas most common?
Like benign soft tissue masses, sarcomas can develop anywhere in the body, but they’re more frequently seen in the abdomen, arms, and legs.
How do tumors form?
Tumors develop when abnormal cells in your body grow out of control, forming a mass. They can grow slowly or quickly. When they appear in the soft tissue, they can often seem round, oval, or sausage-shaped, but soft tissue masses can also be confused with general swelling.
Where do lipomas grow?
These growths are made of fat cells and usually grow slowly. Lipomas often move slightly under the skin when pressed and feel soft to the touch. They can occur anywhere on your body with fat, including: You can also develop lipomas in muscles, bones, or organs, but these occur with less frequency.
Where do sebaceous cysts form?
As a result, sebaceous cysts can contain liquid or semiliquid material, and they usually form on the face, torso, or neck.
Do all soft tissue masses require surgery?
Not all soft tissue masses require medical intervention. However, it’s crucial to get a diagnosis to determine the next steps. If surgery is indicated, treatment involves excision of the mass to ensure the removal of all the abnormal cells.
Is a soft tissue mass cancerous?
Soft tissue masses can be noncancerous (benign) or cancerous (sarcomas).
Soft Tissue Masses: Diagnosis and Surgery For Benign and Cancerous Tumors
Basics of Soft Tissue Masses
- Soft tissue tumors are cell growths that emerge nearly anywhere in the body: in tendons, muscles, ligaments, cartilage, nerves, blood vessels, fat, and other tissues. Patients commonly refer to these masses as lumps or bumps. See Figures 1 and 2. Figure 1 illustrates the appearance of a patient who presented with a benign soft tissue mass in the arm. Figure 2 illustrates the appeara…
Incidence and Acquisition
- Incidence
Some 10,000 new soft tissue and bone sarcomas (cancerous growths) are diagnosed annually in the United States. Benign soft tissue tumors are discovered at a significantly higher rate than sarcomas. Soft tissue tumors affect every segment of the population. However, sarcomas occu… - Acquisition
Evidence suggests that some genetic disorders and mutations predispose people to benign and cancerous soft tissue tumors. Exposure to radiation and environmental carcinogens has been associated with soft tissue tumors. Kaposi’s sarcoma is an example of an infection-induced sof…
Symptoms & Effects on Daily Life
- Initial symptoms
Soft tissue tumors offer little warning. They can emerge as a lump or bump slowly or quickly in any part of the body. The emergence of the mass itself is the most common symptom. It is usually round or oval in its dimensions. It often is painless, causing notice or discomfort only in … - Progression
Depending on the tumor’s etiology, it can grow quickly or slowly. Some soft tissue masses that are initially benign can transform into malignancies. This is often heralded by an abrupt increase in the size of a previously quiescent mass. Research suggests that a malignant mass that emerge…
Risk Factors
- Lifestyle risk factors
Lifestyle and diet are not thought to play a role in the emergence of soft tissue tumors – benign or cancerous. - Injury & trauma risk factors
Historically there have been many case associations between trauma and soft tissue masses, but data does not support trauma as the cause of such masses. More likely is that the trauma drew medical attention to the existing tissue mass. One exception would be a ganglion cyst, a commo…
Prevention
- Soft tissue tumors cannot be prevented, per se, but any discovered mass of unknown etiology that is growing should be evaluated by a specialist. Any sprain or hematoma that lasts longer than six weeks merits additional medical scrutiny.
Diagnosis
- Patients presenting with soft tissue masses are evaluated and their clinical history taken. Diagnostic tests might include X-ray, magnetic resonance imaging (MRI), positron emission tomography (PET) scan, computed tomography (CT) scan, bone scan, and angiogram. See Figures 3 and 4 below. Figure 3 illustrates the appearance of a soft tissue mass on MRI. This “fa…
Treatment
- Upon diagnosis, a soft tissue mass can be observed or prepared for removal from the patient’s body. Benign fat tumors (lipoma), for example, can be observed, rather than removed, with a recommendation of routine surveillance for the patient – an MRI every six to 12 months, depending on the tumor’s location. Patients have lived for decades with slow-growing benign tu…
Additional Resources
Research
- Condition research
Benign tumors do not always require removal or further treatment. With cancerous tumors, a significant volume of ongoing research studies treatment methods. Novel chemotherapy drugs are being tested in multicenter clinical trials, and researchers are trying to identify molecular tar… - Pharmaceutical research
Many new drugs are being tested in clinical trials to treat soft tissue tumors. These trials take time especially because sarcomas (cancerous growth) are rare. Much effort is being focused on drugs to treat those patients with very advanced disease – disease that has metastasized.