scholarly journals Assessment of Referrals into the Soft Tissue Sarcoma Service: Evaluation of Imaging Early in the Pathway Process

Sarcoma ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Emma Rowbotham ◽  
Shaheel Bhuva ◽  
Harun Gupta ◽  
Philip Robinson
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Service Evaluation ◽  
Lesion Size ◽  
Imaging Diagnosis ◽  
Local Hospital ◽  
Patient Demographics ◽  
Tertiary Centre ◽  
Soft Tissue Masses ◽  
Malignant Lesions

Purpose. To prospectively evaluate regional referrals into a soft tissue sarcoma service from outside the tertiary centre with local hospital imaging.Materials and Methods. Consecutive referrals were prospectively assessed for: patient demographics, source, referral date, date received by Multidisciplinary Team (MDT), lesion size, local radiology, MDT radiology and final diagnoses. Radiology diagnosis was categorised benign, indeterminate or malignant by consensus. Delays were defined as >10 days.Results. 112 patients were included with high correlation between local and MDT radiology categrorisation and histology (P=0.54andP=0.49, resp.). There was only a trend for MDT radiology diagnosis to downgrade local imaging diagnosis (n=15,P>0.05). 48 cases (43%) had ultrasound and MRI at referral and 20 (18%) ultrasound only. 85% of cases were benign (lipoma most common), 15% malignant (sarcoma most common). Delay occurred in 34% of cases.Discussion. In comparison to previous series these results show a reduction in benign lesions, increased biopsy and malignancy rate for lesions referred to a tertiary centre when imaging is performed and reviewed by local radiologists.Advances in Knowledge. Imaging triage of soft tissue masses can decrease benign referral rates and increase the proportion of indeterminate and malignant lesions referred to specialist centres.

Color doppler ultrasonography of soft-tissue masses

1998 ◽  
Vol 39 (4) ◽  
pp. 421-426 ◽  
Author(s):  
R. Lagalla ◽  
A. Iovane ◽  
G. Caruso ◽  
M. Lo Bello ◽  
L. E. Derchi
Keyword(s):  
Soft Tissue ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Soft Tissue Tumors ◽  
Color Doppler Ultrasonography ◽  
Tissue Mass ◽  
Vascular Impedance ◽  
The Us ◽  
Soft Tissue Masses ◽  
Malignant Lesions

Purpose: To evaluate the capability of color Doppler ultrasonography to differentiate between benign and malignant soft-tissue tumors. Material and Methods: We reviewed the ultrasonographic (US) and color Doppler (CD) findings in 46 consecutive patients with a palpable periskeletal mass. The presence of 3 or more vascular hila and of tortuous and irregular internal vessels within the lesions was considered an indication of malignancy. The CD diagnosis was compared with that obtained at US alone. Results: The sensitivity and specificity of CD were respectively 85% and 92%; these values were higher than those obtained at US alone, respectively 75% and 50%. Arteriovenous malformations presented as lesions with large internal vessels that had low vascular impedance and were easily diagnosed. The waveform patterns within solid tumors were not specific. Conclusion: At present, US is commonly employed to confirm the presence of a suspected soft-tissue mass, to locate it accurately, and to indicate its nature. CD findings enhance the role of the US technique in such lesions. The combined use of US and CD can allow the differentiation of benign from malignant lesions, and thus provide a better basis for treatment.

scholarly journals A review of paediatric soft tissues masses referred to a tertiary musculoskeletal sarcoma centre

2021 ◽  
Vol 94 (1117) ◽  
pp. 20200790
Author(s):  
Catriona Reid ◽  
Asif Saifuddin
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Soft Tissues ◽  
Malignant Lesion ◽  
Malignant Tumour ◽  
Benign Tumour ◽  
Neoplastic Lesion ◽  
Soft Tissue Masses ◽  
Oncology Unit ◽  
Musculoskeletal Oncology

Objectives: To determine the differential diagnosis of musculoskeletal soft tissue masses in children referred to a specialist musculoskeletal oncology unit. Methods: All children (0–18 y) referred to a specialist musculoskeletal oncology unit over a 20-month period (September 2018–May 2020) were retrospectively reviewed. Demographic data and referral diagnoses were obtained from the electronic patient notes. MRI findings and histopathological results were recorded. The comparison of non-neoplastic, benign neoplastic and malignant diagnoses at the point of referral and final diagnosis was determined. Results: 116 patients were included, 60 (51.7%) males and 56 (48.3%) females with mean age of 10.6 years (3 months–18 years). 69 (59.5%) patients were referred with a suspected sarcoma, 29 (25.0%) with a suspected benign tumour and 18 (15.5%) with a non-neoplastic lesion. A diagnosis was achieved by histological assessment in 61 (52.6%) cases, microbiological assessment in 3 (2.6%) or clinical and imaging assessment in 52 (44.8%). 67 (57.8%) cases had non-neoplastic pathology, 39 (33.6%) a benign tumour, 4 (3.4%) an intermediate-grade tumour, 6 (5.2%) a malignant tumour. Conclusions: Although over half of children referred to a specialist musculoskeletal oncology unit were suspected of having a soft tissue sarcoma at referral, only 5.2% were diagnosed with a malignant tumour. Advances in knowledge: Approximately, 6 of 69 (8.7%) children referred to a specialist musculoskeletal oncology unit with a suspected soft tissue sarcoma will have a malignant lesion. Most paediatric soft tissue masses are non-neoplastic, the commonest diagnosis being a vascular malformation.

Soft tissue masses with “cyst-like” appearance on MR imaging: distinction of benign and malignant lesions

2006 ◽  
Vol 16 (12) ◽  
pp. 2652-2660 ◽  
Author(s):  
Srinivasan Harish ◽  
Justin C. Lee ◽  
Muaaze Ahmad ◽  
Asif Saifuddin
Keyword(s):  
Soft Tissue ◽  
Mr Imaging ◽  
Soft Tissue Masses ◽  
Malignant Lesions

MR imaging of soft-tissue masses: diagnostic efficacy and value of distinguishing between benign and malignant lesions.

1995 ◽  
Vol 164 (5) ◽  
pp. 1191-1199 ◽  
Author(s):  
J S Moulton ◽  
J S Blebea ◽  
D M Dunco ◽  
S E Braley ◽  
G S Bisset ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Mr Imaging ◽  
Diagnostic Efficacy ◽  
Soft Tissue Masses ◽  
Malignant Lesions

Benign Soft Tissue Masses

2019 ◽  
pp. 337-345
Author(s):  
Kevin J. Blount
Keyword(s):  
Soft Tissue ◽  
Clinical Presentation ◽  
Comprehensive Evaluation ◽  
Definitive Diagnosis ◽  
Imaging Appearance ◽  
Soft Tissue Masses ◽  
Malignant Lesions ◽  
Relationship Of ◽  
The Relationship ◽  
Internal Architecture

Chapter 65 discusses benign soft tissue masses, which are much more common than malignant lesions; however, there can be overlap between these categories, and some lesions have features that are indeterminate. In many cases, the clinical presentation is not clearly diagnostic, and patients with soft tissue lesions require additional evaluation with imaging and biopsy. Radiography, MRI, and US serve complementary roles in the workup of soft tissue masses, with MRI providing the most comprehensive evaluation in most cases. Although imaging sometimes cannot confirm a definitive diagnosis, the imaging appearance plays an important role in the workup of soft tissue masses and tumorlike conditions. The most important features to evaluate are the internal architecture of the lesion, defining the anatomic location of the lesion, and assessing the relationship of the soft tissue lesion to surrounding vital structures.

scholarly journals Role of MRI in the differentiation of early myositis ossificans and soft-tissue sarcoma

2021 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
David Pollock ◽  
Satyen Shukla ◽  
James Trainer ◽  
Micheal Pyper
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Myositis Ossificans ◽  
Imaging Features ◽  
Tissue Mass ◽  
Diagnostic Uncertainty ◽  
Diagnostic Certainty ◽  
Malignant Lesions ◽  
Magnetic Resonance Imaging Mri ◽  
Limiting Condition

Myositis ossificans (MO) is a benign, self-limiting condition characterized by abnormal ossification of soft tissue. MO occurs most commonly in the setting of trauma, however can also develop spontaneously. A peripheral rim of zonal calcification within the affected region represents the classic late-stage appearance and is considered virtually pathognomonic. During the early stages of MO development, diagnostic uncertainty may, however, arise as its imaging features can demonstrate overlap with malignant lesions such as soft-tissue sarcoma. This may lead to unnecessary further investigations, including image-guided biopsy. Recognition of the imaging features of early MO using magnetic resonance imaging (MRI) can provide the radiologist with more diagnostic certainty and help obviate the need for unnecessary investigation of this benign entity. This case offers an example of how MRI can achieve this diagnosis during the early multimodality investigation of an indeterminate soft-tissue mass.

scholarly journals Surgery for retroperitoneal soft tissue sarcomas: aggressive re-resection of recurrent disease is possible

2011 ◽  
Vol 93 (1) ◽  
pp. 39-43 ◽  
Author(s):  
R Lochan ◽  
JJ French ◽  
DM Manas
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Median Survival ◽  
Recurrent Disease ◽  
Soft Tissue Sarcomas ◽  
Disease Free Survival ◽  
Patient Demographics ◽  
Included Patient ◽  
Therapeutic Problem

INTRODUCTION Retroperitoneal soft tissue sarcomas represent a relatively rare and complex therapeutic problem where surgery forms the mainstay of treatment and is technically demanding. In this study, we review a single UK centre’s experience with the surgical management of retro-peritoneal soft tissue sarcoma. PATIENTS AND METHODS We present analysis of data on patients treated between 1997 and 2006, our first 75 patients. Data collected from the Access database, included patient demographics, staging modalities, peri-operative details, treatment, outcome, pathological diagnosis and subsequent complications. RESULTS A total of 75 patients (M:F, 44:31) underwent 115 resectional procedures as part of the management of retroperitoneal soft-tissue sarcoma. There were 12 major complications for the 115 procedures (morbidity of 8.69%). The 30-day operative mortality was zero and the 90-day mortality rate was 1.33% (1/75). Follow-up ranged from 16–131 months. The median disease-free survival was 69 months (range, 59-78 months). Recurrences developed in 46 patients; median time to overall recurrence was 13 months (range, 3-71 months). Of these 46, 22 developed localised recurrence, which was amenable to further resection. In the cohort of patients with recurrent disease, median survival in those who underwent surgery was 53 months (range, 30–76 months) and median survival in those who did not undergo surgery was 30 months (range, 18–41 months) and this difference was statistically significant (log rank, P = 0.01). CONCLUSIONS Extensive resectional surgery with minimal morbidity, devoid of mortality is feasible in the treatment of retroperitoneal sarcoma. Development of recurrent disease is a significant factor influencing survival; however, localised recurrences are amenable to surgery and this can lead to improved survival.

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