INTRODUCTION: Peripheral soft tissue masses are problematic for the clinician in terms of diagnostic steps and definitive treatments. Patients usually present with large soft tissue masses and imaging with CT scans usually shows a fat density mass with a “pushing” type of growth and no invasion of peripheral structures. The mass may be superficial to the muscular layers, beneath the muscle or located in both places. Muscle invasion is usually a sign of malignancy.
METHODS: 3 patients presented to the Surgical Oncology Service with large, neglected soft tissue masses of the extremity and peripheral tissues of the back. The three patients were referred by general surgeons from the community due to suspecting the lesions were malignant. All 3 patients underwent resection of the soft tissue tumors.
RESULTS: Histologic examination of the specimens from the 3 patients yielded a benign lipoma in the first, an atypical lipomatous tumor/well differentiated liposarcoma in a 2nd and a definitive liposarcoma in a 3rd case.
CONCLUSION: Large, neglected soft tissue tumors of the periphery should be handled with percutaneous or open biopsy followed by surgical resection. If attempts at diagnosis are inadequate, surgical resection to obtain clear margins should be performed. Close correlation with pathology is essential for subsequent treatment decisions.
