Common Soft Tissue Masses Research Articles

Sonographic Features of Common Soft Tissue Masses in the Extremities

A wide variety of superficial soft tissue masses may be seen in clinical practice and imaging modalities can be helpful in achievement of a definitive diagnosis or limit a differential diagnosis. Among them, ultrasonography is well suited for screening soft tissue masses because of its safety, low cost, and real-time dynamic imaging. The purpose of this article is to review the characteristic sonographic appearance of soft tissue masses in the extremities.

Imaging of sensorineural hearing loss: a pattern-based approach to diseases of the inner ear and cerebellopontine angle

An overview is presented of the common and uncommon diseases of the inner ear and of the cochleovestibular nerve within the internal acoustic meatus and cerebellopontine angle cistern causing sensorineural deafness.An imaging-pattern-based approach is used to help detect disease and narrow the differential diagnosis. Main Messages • The most common soft tissue mass lesions in the cerebellopontine angle are schwannoma and meningioma. • Contrast-enhanced MRI may reveal clinically unsuspected inflammatory, auto-immune or tumoural disease. • Hearing loss may be caused by infection, inflammation or, rarely, perineural tumour spread along the cochleovestibular nerve. • Labyrinthitis may lead to rapidly progressive ossification of the labyrinth.

Methylene Blue-enhanced Arthroscopic Resection of Dorsal Wrist Ganglions

The ganglion is the most common soft tissue mass of the hand and wrist. Over the past 10 to 15 years, there has been a growing interest in arthroscopic treatment of dorsal wrist ganglions. Proposed advantages of arthroscopy include greater motion (particularly wrist flexion), improved cosmesis, and potential to identify/treat other intra-articular pathology. Despite the documented clinical success of arthroscopic ganglion excision, limitations include inconsistent identification of the ganglion stalk. Our described technique offers a means by which to improve visualization of the ganglion stalk intra-articularly to produce a more effective and efficient arthroscopic ganglion excision. During the procedure, a small volume of methylene blue solution is injected into the cyst. Its communication with the joint is apparent arthroscopically, thus identifying the location of the stalk. With the ability to precisely identify the ganglion stalk using an injection of methylene blue, the surgeon can direct the arthroscopic debridement toward the appropriate pathologic tissue. Unnecessary debridement of uninvolved tissue can be avoided with the technique. This also allows for optimal portal placement and, in particular, indicates whether a midcarpal portal should be employed. This should result in fewer recurrences, decreased operative time, and less iatrogenic injury.

Intravascular lipoma from iliofemoral tract

Lipoma is a benign tumour composed of well-differentiated adipocytes and is the most common soft tissue mass. We present a case of an intraluminal lipoma of the iliofemoral axis presenting as lower limb venous obstruction. In our case, definite diagnosis is impossible as there is aspecific symptomatology and radiologic imaging methods are not able to provide diriment data, considering rarity of the disease. Therefore, we could make correct diagnosis only intraoperatively. We preferred a direct reconstruction of the wall of vein. At 12-month follow-up, we have had complete disappearance of symptoms and functional diseases.

A case report of an intermuscular lipoma: presentation, pathophysiology, differential diagnosis

Objective The purpose of this report is to present the case of a 54-year-old female patient with a pathologically confirmed diagnosis of soft tissue lipoma. The clinical presentation, pathophysiology, differential diagnosis, and treatment options for lipoma are described. Clinical Features The patient presented to a chiropractic clinic with painful swelling in the right anterior thigh. Physical examination revealed a palpable mobile mass with minimal tenderness. Intervention and Outcome The initial consultation was with the primary care physician, and it resulted in a sonographic examination as the initial imaging modality to rule out deep venous thrombosis. The result of this examination was negative. Following a delay by additional incorrect diagnoses and treatments, a diagnosis of an intermuscular lipoma was established by magnetic resonance imaging and confirmed on biopsy as a soft tissue lipoma. The patient underwent complete excision of the mass. Conclusion Lipomas are common benign soft tissue masses and should be considered in the differential diagnosis of a thigh mass. Magnetic resonance imaging with contrast depicts the lipomatous mass as having a characteristic high-intensity fat signal without enhancement. It is important for clinicians to have an increased awareness in recognizing the clinical and imaging manifestations of a soft tissue lipoma to optimize an initial diagnosis and treatment.

Soft Tissue Extramedullary Plasmacytoma

We present the uncommon case of a subcutaneous fascia-based extramedullary plasmacytoma in the leg, which was confirmed by the pathology report and followed up until its remission. We report the differential diagnosis with other more common soft tissue masses. Imaging findings are nonspecific but are important to determine the tumour extension and to plan the biopsy.

Soft Tissue Masses in the Foot and Ankle: Characteristics on MR Imaging

Benign neoplasms and tumor-like lesions constitute the majority of soft tissue masses in the foot and ankle. Therefore, malignant tumors are often unsuspected at this site and misdiagnosed clinically, especially if occurring in young individuals with unspecific or long-standing clinical symptoms. In addition to radiography, MR imaging represents the method of choice in evaluation of foot tumors. Because of their relatively characteristic imaging appearance, in most cases of benign soft tissue lesions of the foot and ankle a specific diagnosis can be suggested. Unfortunately, malignant tumors can also arise with nonaggressive imaging features. Diagnostic errors can be avoided if any soft tissue lesion that cannot be specifically diagnosed is regarded as potentially malignant until proved otherwise. This article reviews the MR appearance of the most common benign and malignant soft tissue masses in the foot and ankle together with their clinical, radiographic, and pathological findings.

Imaging of benign and malignant soft tissue masses of the foot.

The foot is a relatively uncommon site of neoplastic and non-neoplastic soft tissue tumors. Although it contains a relatively small amount of somatic soft tissue elements, the foot is considerably rich in tendons, fasciae, retinaculae, and synovium. Corresponding to this distribution of soft tissue elements, some soft tissue lesions, such as giant cell tumor of tendon sheath, fibromatosis, and synovial sarcoma, are commonly seen in this location. Vascular tumors represent common soft tissue masses of the foot as well. Magnetic resonance imaging is the modality of choice in the assessment of soft tissue tumors. The presence of a suspected lesion can be confirmed and tumor margins can be defined accurately. In general, MRI does not provide histologic specificity, but considering some MR features may often help in correctly distinguishing benign from malignant lesions. In addition, characteristic features of the most common benign tumors (i.e., fibromatosis, cavernous hemangioma) and reactive processes of the foot (ganglion cyst, Morton's neuroma) often suggest a specific diagnosis.

Ganglion cysts of the wrist

The ganglion cyst is the most common soft-tissue mass of the hand and wrist. The etiology remains unclear, but it is thought to involve mucoid degeneration. Presenting complaints include pain, tenderness, and deforming mass. Treated nonsurgically, ganglion cysts have a high rate of recurrence. Knowledge of regional anatomy is essential for safe surgical excision. Complete excision of the cyst and pedicle as well as a swath of surrounding joint capsule minimizes the risk for recurrence. Copyright © 2002 by the American Society for Surgery of the Hand