II. Causes: Benign Soft Tissue Mass
- General
- Scalp
- Hands and Feet
- Digital Mucous Cyst
- Ganglion Cyst
- Morton's Neuroma
- Plantar Fibroma
- Tenosynovial Giant Cell Tumor (Giant cell tumor of tendon sheath)
- Foot Schwannoma
- Muscle
- Vascular
- Cystic Lymphangioma, Capillary Lymphangioma or Cavernous Lymphangioma
- Hemangioma
- Pyogenic Granuloma
- Nodular Vasculitis
- Rheumatologic
- Infectious
- Congenital
III. Causes: Malignant Soft Tissue Mass
- Sarcoma
- Other malignancy that may involve soft tissue
IV. Precautions: Red flags for Malignancy
- Firm, deep masses adherent to adjacent structures
- Large lesions >5 cm in diameter (golf ball size)
- Accounts for 90% of malignant lesions
- However, diameter <5 cm does not exclude malignancy
- Consistent size between days (e.g. Sarcoma)
- Some benign masses (e.g. Ganglion Cysts, Hemangiomas) fluctuate in size
- Soft Tissue Masses in childhood
- Children are less likely to have Lipomas or Sebaceous Cysts
V. Exam
- Palpate lesion for size, mobility, consistency and attachment to deep structures
VI. Imaging
-
Ultrasound (POCUS or formal Ultrasound)
- High frequency linear probe
- Identifies tumor size, margins, depth, vascularity and consistency (e.g. cystic)
- Excellent first line, low cost study that can expedite evaluation (esp. POCUS)
- MRI
- Most accurate imaging modality to evaluate Soft Tissue Masses and adjacent structures
- Also identifies necrosis, borders and relationship to fascial planes
- CT
- Consider in adults unable to undergo MRI
- Offers less soft tissue definition than MRI, but can identify bone and vessels, lesion density, calcifications
VII. Evaluation
- Refer suspicious lesions for further evaluation (e.g. needle core biopsy)
- Typical benign lesions may be excised per patient preference
- Send excised lesions for pathology
VIII. References
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Finding (T033) |
| SnomedCT | 297960002 |
| English | skin lump (symptom), skin lump, lump in/on the skin, skin lump:, lump in or on skin, lump in or on skin (symptom), lump in / on the skin, lumps skin, lump skin, skin mass, Cutaneous mass, Skin mass, Lump of skin, Mass of skin, Mass of skin (finding) |
| Spanish | Masa cutánea, masa cutánea (hallazgo), masa cutánea |
| Dutch | huidgezwel |
| German | Raumforderung der Haut |
| Japanese | 皮膚腫瘤, ﾋﾌｼｭﾘｭｳ |
| Czech | Kožní hmota |
| Portuguese | Massa cutânea |
| Italian | Massa cutanea |
| French | Masse cutanée |
| Hungarian | Bőr tömeg |
Ontology: Soft tissue mass (C0457193)
| Concepts | Anatomical Abnormality (T190) |
| SnomedCT | 444905003, 278002000 |
| English | Mass of soft tissue, Mass of soft tissue (finding), soft tissue mass, masses soft tissue, Soft tissue mass, Soft tissue mass (morphologic abnormality) |
| Spanish | masa de partes blandas (hallazgo), Masa de tejidos blandos, masa de partes blandas (anomalía morfológica), masa de partes blandas |
| Portuguese | Massa de tecidos moles |
| Italian | Massa di tessuto molle |
| German | Raumforderung des Weichgewebes |
| French | Masse des tissus mous |
| Dutch | weke delen gezwel |
| Czech | Rezistence měkké tkáně |
| Japanese | 軟部組織腫瘤, ﾅﾝﾌﾞｿｼｷｼｭﾘｭｳ |
| Hungarian | Lágyszövet tömeg |
Ontology: Mass of subcutaneous tissue (C3670836)
| Concepts | Finding (T033) |
| SnomedCT | 309011000009106 |
| English | Mass of subcutaneous tissue (finding), Subcutaneous tissue mass, Mass of subcutaneous tissue |
