Benign and Malignant Soft-Tissue Tumors Clinical Presentation

Updated: Mar 27, 2017
  • Author: Vinod B Shidham, MD, FRCPath; Chief Editor: Harris Gellman, MD  more...
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Presentation

History

A mass is the most common sign of a soft-tissue tumor. It usually is painless and does not cause limb dysfunction. However, depending on the anatomic location of the tumor, it may cause pain or neurologic symptoms by compressing or stretching nerves, by irritating overlying bursae, or by expanding sensitive structures. A rapid rate of increase in the size of a mass should arouse suspicion that the lesion is malignant.

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Physical Examination

Physical examination can be used to determine the location and size of a mass and to exclude other, more common causes of pain. Whether the mass is deep or subcutaneous, transilluminates (cysts), and adheres to underlying structures also can be gleaned from physical examination. Regional lymph nodes should be examined as well. Neurovascular examination is useful for the detection of either primary or secondary tumor involvement.

Extremity masses larger than 5-7 cm and deeper than subcutaneous tissue favor a diagnosis of a malignant soft-tissue tumor. However, as many as 30% of soft-tissue sarcomas occur in subcutaneous tissue and exhibit relatively less aggressive behavior. [20]

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