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Soft Tissue Masses: Diagnosis and Surgery for Benign and Cancerous Tumors (Sarcoma)

Last updated Friday, January 18, 2008

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About

What is masses?

Edited By: Jason S. Weisstein, M.D, MPH

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. IMAGE 1 illustrates the appearance of a patient who presented with a benign soft tissue mass in the arm. Image 2 illustrates the appearance of a sarcoma in the thigh. Note the large size of the mass along with the overlying skin changes in Image 2.

Soft tissue tumors can be cancerous or benign. Benign masses are thought to occur 10 times more frequently than cancerous growths (referred to medically as sarcomas). Generally these growths are roughly round in shape, but they also can be or elliptical or elongated like a sausage. Masses greater than 5 cm (2 inches) carry the highest risk of being malignant and merit a medical evaluation.

They can feel firm or soft. Benign masses are more likely to be painful to the touch, such as with an abscess. Benign tumors also tend to grow more slowly, and many are smaller than 5 cm (2 inches) at their longest point.

Sarcomas (cancerous growths) more often are painless. Cancerous masses are more likely to grow rapidly, and to have fingerlets or satellite lesions around them.

According to the National Cancer Institute, about 43 percent of sarcomas occur in arms and legs; 34 percent occur in and around internal organs; 10 percent occur in the chest and back region; and 13 percent occur in other locations.

The masses – benign or cancerous – come to clinical attention more quickly when they are located in the arms and legs, as opposed to the chest or abdomen, because less room exists in arms and legs for such masses to be mistaken for other bodily structures.

What symptoms indicate that masses needs immediate medical attention?

A newly found soft tissue mass is rarely an emergent condition. Not all soft tissue masses require surgery, and removal of a known benign tumor can be safely delayed. However, any suspected (cancerous growth) should be worked-up and biopsied as soon as possible so further treatment can be rendered.

Any newly discovered mass of unknown origin that is growing should be evaluated by a specialist. Any sprain or hematoma (bruise) that lasts longer than six weeks merits additional medical scrutiny for the possibility of sarcoma (cancerous growth).

What are some common misconceptions (common misunderstandings or myths) about masses?

Depending on its location, a soft tissue mass often is initially misdiagnosed as a muscle sprain, hematoma, or old trauma that will heal in time. 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. Because the tissue masses often cause no pain, people tend to think the bumps are not harmful.

Surgery for masses at the University of Washington

If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.


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