Chapter 18 - Soft tissue masses
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Pt has history of leukemia and has painless soft mass in tissue. There is enlargement of lymph nodes noted. What type of mass is present?
Pt has painless, fairly well-demarcated, slow growing, firm, encapsulated tumor. It is found in connection with skin. What is it?
Pt has red-brown in color lesion. It is well circumscribed benign nodule. It is associated with tendon sheath. What is it?
- Giant cell tumor of tendon sheath.
- These lesions occasionally become malignant and treatment is excision with surrounding normal skin, to prevent metastasis.
35 year old male presents with a slow growing somewhat elevated, slightly protruding structure that is fixed to the skin and some hyperpigmentation. What type of tumor?
Dermatofibrosarcoma protuberans (Darier's tumor).
Pt has slow growing lobulated, rubbery, firm mass. This lesion tend to metastasize.
A man (key word man) has a benign superficial subcutaneous soft tissue mass. The lesion is found in GI tract.
There are two types of smooth muscle origin lesions?
Leiomyoma and Leiomyosarcoma
Name one skeletal muscle soft tissue mass?
Rhabdomyoma: extrememly rare benign skeletal muscle tumor usually occuring in the tongue, neck muscles, larynx uvula, nasal cavity, axilla, vulva, and heart.
Name 3 adipose tissue masses
- Lipoma: benign usually painless tumor derived from fat cells.
- Soft, movable, subcutaneous nodule
- Rarely found on the foot.
- Can transform to liposarcoma
- Liposarcoma: slow growing malignant tumor of adipose tissue.
- Pain may be present depending on involvement
- Most commonly seen in upper thigh, buttocks, or back
- More firm than lipoma, less freely moveable
- Treatment may include amputation, chemotherapy, irradiation
- One of the most common soft tissue sarcomas in adults, however it's still about 100 X less common than a benign lipoma.
- Piezogenic papule
- -Benign herniation of subcutaneous fat into the dermal connective tissue
- -Seen most frequently on the lateral and medial aspect of the weight bearing heel.
- -More common in obese persons due to pressure
- -Can be painful and may become necrotic
- -These lesions may give "cobblestone" appearance
Name 3 nerve tissue soft tissue masses
- benign neoplastic lesion that arises from schwann cells
- The schwannoma tumor group includes; neurilemmomas and neurofibromas
- A type of schwannoma
- when multiple cutaneous lesions are noted with cafe au lait spots the condition is called von recklinghausen's disease.
- More prone to become malignant as compared to neurilemmoma
- Feel rubbery
- -type of schwannoma
- -tend to favor the flexor surfaces
- malignant transformation is extrememly rare
Name 2 synovial joint masses
- Pigmented Villonodular synovitis:
- -Symptoms usually have been present for a few years and include pain, joint effusion, and hemarthrosis, limited ROM
- -The synovium will appear red-brown in color due to the hemosiderin found in the tissue.
- Synovial Sarcoma
- -highly malignant tumor arising from undifferentiated mesenchymal cells in tendons, tendon sheaths, or joint capsue.
- Most common malignant soft tissue lesion in the foot.
What is the most common malignant soft tissue lesion in the foot?
- Synovial sarcoma: highly malignant tumor arising from undifferentiated mesenchymal cells in tendons, tendon sheaths, or joint capsule.
- -affects people in their 20's most commonly.
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