Soft Tissue Masses: Diagnosis and Surgery for Benign and Cancerous Tumors (Sarcoma)
Last updated Friday, January 18, 2008
Diagnosis and evaluationHow is masses diagnosed? 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).What tests may be used to diagnose masses? 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.
Will diagnosing masses cause pain, side effects, or invasive techniques? How are these dealt with? 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.What health care professionals may help diagnose masses? 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 can a doctor specializing in masses be found? 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 Orthopaedic
Surgeons or the Musculoskeletal Tumor Society are
reliable resources for identifying surgeons with the above-mentioned
qualifications. 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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