Soft Tissue Tumours Flashcards
What 10 bits of info do you need to obtain from a soft tissue tumour?
Size and site Definition- Well or ill defined Consistency- Cyst, solid, soft, hard Surface- Smooth or irregular Mobile or fixed- To skin or deeper tissue Temperature Transilluminable- Fluid filled Pulsatility Overlying skin changes Local lymphadenopathy
What factors suggest a benign lesion?
Small, fluctuation in size, well defined, cystic/fluid filled, soft or fatty.
What factors suggest a malignant lesion?
Large lesion (>5cm), rapid growth, solid, ill defined, irregular surface, lymphadenopathy and systemic involvement.
What are the two best investigations for identifying soft tissue lesions?
MRI and biopsy
What are the three important benign soft tissue tumours we need to know?
Lipoma
Giant Cell Tumour of Tendon Sheath
Pigmented villonodular synovitis (PVNS)
What is a lipoma?
Proliferation of fat in subcutaneous fat or muscle.
How does a lipoma look?
Large and ill defined. Most common benign soft tissue tumour.
What is a Giant Cell Tumour of Tendon Sheath?
Small firm swelling under tendon sheath of fingers.
How does a Giant Cell Tumour of Tendon Sheath look like?
Pigmented and have multinucleated giant cells.
How does Giant Cell Tumour of Tendon Sheath present?
Can be painful and erode surrounding structures.
How do you treat Giant Cell TUmour of Tendon SHeath?
Excise but high chance of recurrence.
What is Pigmented Villonodular Synovitis (PVNS)
Same of Giant Cell Tumour of Tendon Sheath but in synovial joint.
What is the suffix for malignant soft tissue tumours?
‘Sarcoma’
Are sarcomas rare or common?
Pretty rare
What is the common age for developing a sarcoma?
50-70
How do you treat a sarcoma?
Excise and treat with radio and chemotherapy as appropriate.
What is an angiosarcoma?
Malignant tumour of blood vessel
What is a fibrosarcoma?
Malignant tumour of fibrous tissue
What is a liposarcoma?
Malignant tumour of fat
What is a rhabdomyosarcoma?
Malignant tumour of skeletal muscle
What is a synovial sarcoma?
Malignant tumour of synovial lining
What are the five types of malignant soft tissue tumours we need to know?
Liposarcoma Fibrosarcoma Angiosarcoma Rhabdomyosarcoma Synovial Sarcoma
What are the four non-tumour swellings of soft tissue we need to know?
Ganglion cyst
Bursitis
Sebaceous cyst
Abscess
What is a ganglion cyst?
A herniation of the capsule round a synovial joint or tendon sheath. Can be developmental or traumatic.
How do ganglion cysts usually present?
Well defined, firm and transilluminated
How do you treat a ganglion cyst?
Usually just leave but if problematic excise.
Give two examples of ganglion cysts.
Baker’s cyst and wrist ganglion
What is a Baker’s cyst?
Ganglion cyst found in the popliteal fossa.
Can be swollen and painful but usually asymptomatic.
What are come causes of a Baker’s cyst and some complications of its rupture?
OA, RA, meniscal tear
DVT and compartment syndrome
What is bursitis?
Inflammation of the bursa (fluid filled sack round joint the prevent friction).
What causes bursitis?
Repeated pressure, trauma, bacterial infection and gout.
Where are common places to get a bursitis?
Pre-patella
Olecranon
Metatarsals (Bunion)
How do you treat a bursitis?
Usually leave but can reoccur so may need to be excised.
What is a sebaceous cyst?
Skin swelling that can masquerade as MSK
What is an abscess?
Walled off area of infection. Avascular.
What can cause an MSK abscess?
Infection, penetrating wound, bursitis, cellulitis
How do you treat an abscess?
Incise and drain. Antibiotics.
