Soft Tissue Tumours

Question 1

What 11 findings should you look for on examination of a soft tissue swelling?

Answer 1

1. site
2. size
3. definition
4. mobility
5. consistency
6. surface
7. temperature
8. transilluminate
9. pulsatility
10. overlying skin changes
11. local lymphadenopathy

Question 2

features suggestive of a benign soft tissue neoplasm

Answer 2

smaller size 
fluctuation in size (malignant tumours dont regress) 
cystic lesions 
well-defined lesions 
fluid-filled lesions

Question 3

features suggestive of a malignant soft tissue neoplasm

Answer 3

larger size 
continually rapidly growing and non-fluctuant 
solid lesion 
ill-defined 
lymphadenopathy
irregular surface 
systemic symptoms

Question 4

commonest benign soft tissue tumour

Answer 4

lipoma

Question 5

what is a lipoma

Answer 5

neoplastic proliferation of fat (most commonly subcutaneous location)

Question 6

what is a giant cell tumour of tendon sheath

Answer 6

a benign small firm swelling usually on the flexor tendon sheath of a finger

Question 7

presentation of a giant cell tumour of tendon sheath

Answer 7

small and firm
+/- pain
erode bone if large enough
macroscopically pigmented

Question 8

Tx of a giant cell tumour of tendon sheath

Answer 8

Excision - however there is a high recurrence rate

Question 9

what is a ‘sarcoma’

Answer 9

malignant soft tissue tumour arising from the connective tissues

Question 10

angiosarcoma

Answer 10

malignant tumour from blood vessels

Question 11

fibrosarcoma

Answer 11

malignant tumour from fibrous tissue

Question 12

liposarcoma

Answer 12

malignant tumour from fat tissue

Question 13

rhabdomyosarcoma

Answer 13

malignant tumour from skeletal muscle

Question 14

Mx of a sarcoma

Answer 14

imaging and biopsy to confirm malignancy

surgery - radical or WLE with limb salvage surgery or amputation

adjunctive XRT/chemo