Soft Tissue Masses: Diagnosis and Surgery for Benign and Cancerous Tumors (Sarcoma)
Last updated Thursday, August 13, 2009
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Diagnosis and evaluationDiagnosis 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. IMAGE 3 illustrates the appearance of a soft tissue mass
on MRI. This “fatty mass” in light color is a lipoma. IMAGE 4 illustrates the
appearance of a sarcoma (cancerous growth) in the back of a person’s thigh.
With
this information in hand, the physician would biopsy the mass to diagnose its
etiology. If a biopsy is needed, the surgeon who does the biopsy should be the
person who will remove the mass. If the mass is benign, often surgeons will
remove it immediately, but it may not require removal. If the mass is
malignant, it likely will be treated with surgery, chemotherapy or radiation
(or a combination thereof).Diagnostic tests 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. IMAGE 5 is the appearance of a soft tissue mass on the
chest wall. CT scan (IMAGE 6) was necessary to precisely localize the area of
the mass. The mass was found to arise from a rib.
These
tests indicate the tissue mass’ orientation within and across surrounding
structures, such as nerves and bones, and the mass’ aggressiveness and any
suggestion that it has metastasized, or will.
Effects The
imaging required to work-up a soft tissue tumor is fairly painless. If contrast
is used for a CT scan, then an intravenous line may be needed. Some people get
claustrophobic in the MRI scanner machine, and need medicine to prevent
anxiety. A biopsy of a soft tissue tumor causes minimal pain and discomfort.Health care team 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.Finding a doctor Surgical
care of soft tissue tumors should be performed in specialty centers
well-practiced in sarcoma (cancerous growth) surgeries. There is good evidence
in the medical literature to support this idea.
Surgeons
remove some 40,000 soft tissue masses every year in the United States; 10,000
of these are sarcomas – a relatively low number, compared with incidences of breast
cancer or prostate cancer, for example. Given this, relatively fewer surgeons
in the United States specialize in the care of soft tissue tumors, malignant or
benign.
Patients
should seek out a surgeon who has a high volume practice and much experience in
treating soft tissue tumors. The American Academy of Orthopedic
Surgeons or the Musculoskeletal Tumor Society are
reliable resources for identifying surgeons with the above-mentioned
qualifications.
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