scholarly journals The safety of primary surgical excision of small deep indeterminate musculoskeletal soft tissue masses

2021 ◽  
Vol 94 (1117) ◽  
pp. 20200713
Author(s):  
Michèle Calleja ◽  
Qasim Afzaal ◽  
Asif Saifuddin
Keyword(s):  
Soft Tissue ◽  
Residual Disease ◽  
Surgical Excision ◽  
Lesion Size ◽  
Safe Procedure ◽  
Deep Soft Tissue ◽  
Tissue Mass ◽  
Oncology Service ◽  
Soft Tissue Masses ◽  
Musculoskeletal Oncology

Objective: To determine the suitability of primary excision of small indeterminate deep soft tissue masses presenting to a tertiary musculoskeletal oncology service. Methods and materials: Review of all patients referred to a specialist musculoskeletal oncology service over a 20-month period with a deep indeterminate soft tissue mass by non-contrast MRI criteria that was recommended for primary surgical excision due to relatively small size (<30 mm). Data collected included age, gender, site and maximal size of the lesion, and final histological diagnosis for excised lesions. Results: 85 patients were included, mean lesion size being 12 mm (range 5–29 mm). Primary surgical resection had been undertaken in 69 cases (81.2%) by the conclusion of data collection, 36 males and 33 females with mean age of 45.6 years (range 11–80 years). Of these, 11 cases (15.9%) were non-neoplastic, 53 (76.8%) were benign, 1 (1.4%) was intermediate grade, while 4 (5.8%) were malignant including 3 synovial sarcomas. Two of these were treated with re-excision of the tumour bed showing no residual disease, with no evidence of local recurrence at a mean of 10.7 months post-excision. Conclusion: Primary surgical excision of small deep soft tissue masses that are indeterminate by non-contrast MRI criteria is considered a safe procedure when undertaken in a specialist musculoskeletal oncology service, with only 4 of 69 cases (5.8%) being malignant. Advances in knowledge: Small indeterminate deep soft tissue masses can safely be treated with primary excision in the setting of a specialist musculoskeletal oncology service.

scholarly journals Giant epidermal cyst of the foot

2014 ◽  
Vol 142 (9-10) ◽  
pp. 607-609 ◽  
Author(s):  
Melih Malkoc ◽  
Özgür Korkmaz ◽  
Yıldıray Genç ◽  
Ferhat Say ◽  
Mahmut Aytekin
Keyword(s):  
Soft Tissue ◽  
Epidermoid Cyst ◽  
Soft Tissue Mass ◽  
Surgical Excision ◽  
Epidermal Cyst ◽  
Pathology Report ◽  
X Rays ◽  
Tissue Mass ◽  
Palpable Mass ◽  
Soft Tissue Masses

Introduction. Epidermoid inclusion cysts are usually composed of epidermal elements implanted into the dermal layers. Patients are seen in the outpatient clinics with a mass. Most of the complaints are mechanical and cosmetic problems. Case Outline. A 34-year-old female patient was admitted to our clinic because of swelling and pain in her right foot. A palpable mass was detected in the first web. On the x-rays of the foot no osseous lesion was detected. There was a soft tissue mass in the first web according to MRI report. Soft tissue mass was excised and sent to pathology. According to pathology report the mass was an epidermoid cyst 5?2?1.5 cm in size. There were no problems during follow-up of the patient for 6 months after surgery. The patient had no swelling in the foot and had no additional complaints on checkup. Conclusion. In the differential diagnosis, we should take into consideration epidermoid cyst of large soft tissue masses of the foot. Surgical excision should be done within the appropriate limits.

scholarly journals Lipoblastomas and liposarcomas in paediatric patients: A case series

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052098136
Author(s):  
Joyce J.L.H McRae ◽  
Asra Hashmi ◽  
Andrei Radulescu ◽  
Cody S. Carter ◽  
Faraz A. Khan
Keyword(s):  
Soft Tissue ◽  
Histological Examination ◽  
Clinical Case ◽  
Soft Tissue Mass ◽  
Case Series ◽  
Surgical Excision ◽  
Tissue Mass ◽  
Paediatric Patients ◽  
Soft Tissue Masses

Lipoblastomas and liposarcomas are rare causes of soft tissue masses in paediatric patients. In this retrospective clinical case series we identified 11 patients from our paediatric database (10 with a lipoblastoma and one with a liposarcoma) who had attended our hospital between 1998 and 2019. The median age of patients with lipoblastoma was 29 months. All lipoblastoma cases were managed with surgical excision and histological examination. The 18-year old patient with liposarcoma presented with a metastatic and unresectable tumour that was unresponsive to chemotherapy and radiation. Our experience demonstrates the importance of differentiating the type of soft tissue mass in children.

scholarly journals Soft tissue masses: distribution of entities and rate of malignancy in small lesions

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Felix G. Gassert ◽  
Florian T. Gassert ◽  
Katja Specht ◽  
Carolin Knebel ◽  
Ulrich Lenze ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Benign Lesion ◽  
Maximum Diameter ◽  
Histopathological Diagnosis ◽  
Tumor Diameter ◽  
Mr Images ◽  
Tissue Mass ◽  
Malignancy Rate ◽  
Significant Difference ◽  
Soft Tissue Masses

Abstract Background Small soft tissue masses are often falsely assumed to be benign and resected with failure to achieve tumor-free margins. Therefore, this study retrospectively investigated the distribution of histopathologic diagnosis to be encountered in small soft tissue tumors (≤ 5 cm) in a large series of a tertiary referral center. Methods Patients with a soft tissue mass (STM) with a maximum diameter of 5 cm presenting at our institution over a period of 10 years, who had undergone preoperative Magnetic resonance imaging and consequent biopsy or/and surgical resection, were included in this study. A final histopathological diagnosis was available in all cases. The maximum tumor diameter was determined on MR images by one radiologist. Moreover, tumor localization (head/neck, trunk, upper extremity, lower extremity, hand, foot) and depth (superficial / deep to fascia) were assessed. Results In total, histopathologic results and MR images of 1753 patients were reviewed. Eight hundred seventy patients (49.63%) showed a STM ≤ 5 cm and were therefore included in this study (46.79 +/− 18.08 years, 464 women). Mean maximum diameter of the assessed STMs was 2.88 cm. Of 870 analyzed lesions ≤ 5 cm, 170 (19.54%) were classified as superficial and 700 (80.46%) as deep. The malignancy rate of all lesions ≤ 5 cm was at 22.41% (superficial: 23.53% / deep: 22.14%). The malignancy rate dropped to 16.49% (20.79% / 15.32%) when assessing lesions ≤ 3 cm (p = 0.007) and to 15.0% (18.18% / 13.79%) when assessing lesions ≤ 2 cm (p = 0.006). Overall, lipoma was the most common benign lesion of superficial STMs (29.41%) and tenosynovial giant cell tumor was the most common benign lesion of deep STMs (23.29%). Undifferentiated pleomorphic sarcoma was the most common malignant diagnosis among both, superficial (5.29%) and deep (3.57%) STMs. Conclusions The rate of malignancy decreased significantly with tumor size in both, superficial and deep STMs. The distribution of entities was different between superficial and deep STMs, yet there was no significant difference found in the malignancy rate.

Chalastospora gossypii in a Maine Coon cat: case report and literature review

2021 ◽  
pp. 104063872110222
Author(s):  
Samantha M. Norris ◽  
Paula A. Schaffer ◽  
Noah B. Bander
Keyword(s):  
Soft Tissue ◽  
Needle Aspiration ◽  
Tissue Mass ◽  
Large Numbers ◽  
Formalin Fixed Paraffin ◽  
Formalin Fixed Paraffin Embedded ◽  
Soft Tissue Masses ◽  
Subcutaneous Mass ◽  
The Right ◽  
A Minor

A 15-y-old castrated male Maine Coon cat was evaluated for an ulcerated soft tissue mass on the right hindlimb that had been observed for 4 mo and had grown rapidly. A 3 × 3 cm soft, raised, amorphous, and ulcerated subcutaneous mass was observed on the lateral right metatarsus. In-house cytology via fine-needle aspiration was nondiagnostic. Incisional biopsy of the mass and further staging was declined, and amputation was elected. The amputated limb was submitted for histopathology, which revealed severe chronic nodular granulomatous dermatitis and multifocal granulomatous popliteal lymphadenitis with large numbers of intralesional fungal hyphae. Fungal PCR and sequencing on formalin-fixed, paraffin-embedded tissue identified Chalastospora gossypii. No adjunctive therapy was elected at the time. The patient has done well clinically 1 y post-operatively. C. gossypii is a rare microfungus found worldwide and is considered a minor pathogen of several plants. To our knowledge, infection by this fungus has not been reported previously in veterinary species. Features in our case are comparable to other mycotic infections. Nodular granulomatous mycotic dermatitis and cellulitis, although uncommon, should be a differential for soft tissue masses in veterinary species; C. gossypii is a novel isolate.

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 Subungual Glomus Tumor- Clinical Presentation And Treatment

2014 ◽  
Vol 3 (2) ◽  
pp. 45-48 ◽  
Author(s):  
Shyamal Chandra Debnath ◽  
Suman Kumar Roy ◽  
RR Kairy
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Tumor ◽  
Clinical Presentation ◽  
Glomus Tumor ◽  
Rare Condition ◽  
Surgical Excision ◽  
Tissue Mass ◽  
Delay In Diagnosis ◽  
Nail Deformity

Glomus tumor is a rare condition and constitutes only 1 % of all soft tissue tumor of body. Glomus tumor is familiar for its unusual presentation and long standing symptoms due to delay in diagnosis. Authors have presented the clinical behavior and treatment of 7 patients with subungual soft tissue mass. Following surgical excision, all patients cured of symptoms, at the end of follow up, no recurrence occurred; post operative nail deformity was insignificant. DOI: http://dx.doi.org/10.3329/bdjps.v3i2.18250 Bangladesh Journal of Plastic Surgery July 2012, 3(2): 45-48

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.

CHARACTERISTICS OF SOFT TISSUE MASS IN THE HAND BY ULTRASONOGRAPHIC EXAMINATION

2005 ◽  
Vol 09 (01) ◽  
pp. 45-51
Author(s):  
Alexander Blankstein ◽  
Aharon Chechick ◽  
Abraham Adunski ◽  
Uri Givon ◽  
Yigal Mirovski ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Mass ◽  
Wrist Joint ◽  
Imaging Modality ◽  
Routine Practice ◽  
X Rays ◽  
Diagnostic Challenge ◽  
Tissue Mass ◽  
Soft Tissue Masses ◽  
The Right

Soft tissue masses are amongst the commonest complaints encountered in orthopedic practice. Of these, masses found in the hand and the wrist are presented at higher frequency. They are often painful and may cause limitation of movement. This work describes the prevalence and the nature of soft tissue masses in the hand and wrist encountered in routine practice. This work was performed to assess the characteristics of soft tissue mass in the hand and the effectiveness of ultrasonography in the diagnosis of soft tissue masses and their differentiation from other lesions in the hand and wrist. Orthopedic surgical conditions that involve soft tissue in the hand and wrist may remain a diagnostic challenge when clinical diagnosis is uncertain and standard X-rays are non-diagnostic. High resolution ultrasound is widely available, non-invasive, without damage of radiation, imaging modality that can help the diagnosis. We reviewed retrospectively 25 patients with soft tissue masses. We compared the ultrasound findings with the histological findings in seven operated patients. A substantial majority of these lesions occurred in the right hand: 79% of the lesions were in the dorsal aspect of the hand, of which 37% were distal to the wrist joint, among them 42% at wrist either radial or ulnar; and 21% of the lesions were found in the volar aspect, among them 17% at wrist aspect, either radial or ulnar side. No predisposing factors could be found. The findings of this study reaffirm the utility of ultrasonography as primary diagnostic tool in routine orthopedic practice.

scholarly journals Clinical features of bone metastasis with extraosseous soft-tissue mass in prostate cancer patients

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20180042
Author(s):  
Masaya Kawaguchi ◽  
Hiroki Kato ◽  
Masahiro Nakano ◽  
Satoshi Goshima ◽  
Masayuki Matsuo
Keyword(s):  
Prostate Cancer ◽  
Soft Tissue ◽  
Clinical Features ◽  
Specific Antigen ◽  
Progression Free Survival ◽  
Tissue Mass ◽  
Poor Prognostic Factor ◽  
Soft Tissue Masses ◽  
Psa Nadir ◽  
Initiation Of Therapy

Objective: This study aimed to compare the differences in the clinical features of prostate cancer (PC) bone metastases (PCBMs) with and without extraosseous soft-tissue masses (ESTMs). Methods: Among 720 consecutive patients with histopathologically or clinically diagnosed PC, PCBMs were identified in 48 (7%) patients at initial diagnosis before receiving treatment. CT images of PCBMs were assessed and classified into two groups: PCBMs with and without ESTMs. Clinical features of PCBMs with and without ESTMs were compared. Results: We found ESTMs in 15 (31%) patients diagnosed with PCBMs, and 33 (69%) patients diagnosed with PCBMs did not have ESTMs. The initial prostate-specific antigen (PSA) levels (median, 1031 vs 247 ng ml−1; p < 0.05) and PSA reduction rates (median, 99.97 vs 99.40 %; p < 0.05) were significantly greater in PCBMs with ESTMs than in PCBMs without ESTMs. No significant differences were observed in terms of age, Gleason sum score, PSA nadir, time from the initiation of therapy to PSA nadir, PSA doubling time, PSA progression-free survival, or overall survival between patients having PCBMs with and without ESTMs. Conclusion: Both initial PSA levels and PSA reduction rates were higher in PCBMs with ESTMs than in PCBMs without ESTMs; however, no significant differences were observed in other clinical features. Advances in knowledge: ESTMs in patients with PCBMs were not a poor prognostic factor.

Paratesticular Soft-Tissue Masses in Orchiectomy Specimens: A 17-Year Survey of Primary and Incidental Cases From One Institution

2017 ◽  
Vol 25 (6) ◽  
pp. 480-487 ◽  
Author(s):  
David S. Priemer ◽  
Karen Trevino ◽  
Shaoxiong Chen ◽  
Thomas M. Ulbright ◽  
Muhammad T. Idrees
Keyword(s):  
Soft Tissue ◽  
Spermatic Cord ◽  
Soft Tissue Mass ◽  
Young Patients ◽  
Benign Neoplasm ◽  
Rete Testis ◽  
Benign Neoplasms ◽  
Tissue Mass ◽  
Common Diagnosis ◽  
Soft Tissue Masses

The paratestis (PT) is defined by the testicular tunics, epididymis, spermatic cord, rete testis, and embryonic remnants. It gives rise to a large diversity of pathologies, including those of soft tissue, which may prompt orchiectomy. We performed a 17-year search of our database for orchiectomies for a PT soft-tissue mass. In a total of 4741 orchiectomy specimens, 138 orchiectomies were performed for primary neoplastic or nonneoplastic masses of the PT soft tissue or had an incidental PT soft-tissue mass. Of these, 65.9% were neoplastic. The mean age was 40.2 years (range: <1 to 87 years) and was similar for neoplastic and nonneoplastic lesions. The most common malignancies were rhabdomyosarcoma (31/63 malignancies), liposarcoma (19/63), and leiomyosarcoma (5/63), with the former occurring in younger patients (average: 18.3 years). No malignancies were incidental. The most common benign neoplasm was spermatic cord lipoma (24/28 of benign neoplasms); however, most were incidental. This was followed by leiomyoma (3/28) and hemangioma (1/28). The most common nonneoplastic lesions were adrenal rests (22/47 nonneoplastic cases); however, all were incidental findings. Of 47 nonneoplastic masses, 22 prompted orchiectomy, and of these, the most common diagnosis was fibrous/nodular periorchitis (11/47). Of 88 nonincidental lesions, 25 were either benign neoplasms (3/25) or nonneoplastic (22/25). These data indicate that PT soft-tissue neoplasms prompting orchiectomy are disproportionately rhabdomyosarcomas, though these are principally in young patients. In older patients, malignancies are more frequently liposarcomas. However, almost one-third of orchiectomies performed for PT soft-tissue masses yield benign lesions, indicating an opportunity to reduce unnecessary procedures.

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