Fibrosarcoma Clinical Presentation

Updated: Aug 22, 2016
  • Author: Ian D Dickey, MD, FRCSC; Chief Editor: Harris Gellman, MD  more...
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Presentation

History and Physical Examination

Sarcomas involving bone often present with pain and swelling after a long duration of symptoms. They may even grow large enough to threaten the structural integrity of the bone and cause pathologic fracture as the initial presentation.

Generally, lesions that involve more than 50% of the bone cortex, that are larger than 2 cm, or that involve the medial calcar of the femur are associated with the greatest risk of fracture. A prior history of bone infarct, irradiation, or other such risk factors should alert the physician to the possibility of a secondary fibrosarcoma.

Soft-tissue sarcomas most often present as painless masses. The time to presentation, however, is often shorter than with lesions involving bone. Because these lesions frequently arise deep to the muscular fascia, they may become extremely large tumors before being diagnosed.

Most lesions occur around the knee, in the proximal femur and hip region, or in the proximal arm. Findings are nonspecific and can vary from a fixed, firm mass to a localized area of tenderness. Neurologic or vascular changes are late findings and indicate extensive disease involvement.