The Hip: Preservation, Replacement and Revision

Tumors of Soft Tissue

 


     - Bone Tumors
     - Biopsy
     - European Cancer Institute - Soft Tissue Sarcomas
     - Metastatic Tumors
     - MRI
     - Stage Classification

Tissue type:


- Osseous
     - Myositis ossificans
     - Extraosseous osteosarcoma
- Carilaginous:
     - Chondroma
     - Extraosseous chondrosarcoma
     - Synovial Chondromatosis
- Fibrous:
     - Fibroma
     - Fibrosarcoma
     - Desmoplastic Fibroma
     - Fibromatosis
     - Malignant fibrous histiocytoma
- Synovial
     - PVS
     - Synovial sarcoma
- Vascular:
     - Hemangioma
     - Angiosarcoma
- Fatty
     - Lipoma
     - Liposarcoma 
- Neural
     -
 Neurolemmoma
     - Neurosarcoma
     - Neurofibroma
     - Neurofibrosarcoma
     - Neuroblastoma
- Muscular:
     - Leiomyoma
     - Leiomyosarcoma
     - Rhabdomyoma
     - Rhabdomyosarcoma
- Skin/Dermis
     - Malignant Melanoma
     - Squamous Cell Carcinoma
- Unknown
     -
GCT of Tendon Sheath
     - Epithelioid Sarcoma
     - Mesenchymoma 
     - Clear Cell Carcoma 

- Discussion:
    - primary goal is to determine whether the mass is benign or malignant;
    - prior to biopsy the physician should determine:
         - whether the mass is above or below the fascia (deep lesions are more often malignant);
         - exceptions are MFH and leiomyosarcoma which can occur in the subcuanteous tissues;
         - anecdotally malignant superficial lesions will not appear as a discrete circular mass, but there are always exceptions;
         - size of mass:- if mass is > five cm, esp if it is deep and in thigh, it is likely to be a sarcoma;
         - whether there are visible changes on x-ray (such as soft tissue calcification which can be seen in synovial sarcoma);
         - it has been recommended by Springfield DS (1996) that superfical masses feel like fat (lipoma), which do not cause pain and which have not changed in size can be followed clinically;
                    - Biopsy: complicated and risky.
         - masses which are painful, have changed in size, or show suspicious x-ray findings, will require MRI and biopsy (either incisional biopsy or by needle)
         


Unplanned Excision of Soft-Tissue Sarcomas

Primary myectomy for sarcoma

Ultrasound imaging as a screening study for malignant soft-tissue tumors.

Surgical margins for soft-tissue sarcoma

The surgical margin in soft-tissue sarcoma

Wound healing complications in soft tissue sarcoma management: comparison of three treatment protocols.

Selection bias in treatment of soft-tissue sarcoma.

An evaluation of two methods of limb salvage in extremity soft-tissue sarcomas.

Biopsy of soft-tissue tumors.

Wound complication in surgery of soft tissue sarcoma. Analysis of 103 consecutive patients managed without adjuvant therapy.

Chemotherapy for soft-tissue sarcomas.

Principles for pathologic-anatomic diagnosis and classification of soft-tissue sarcomas.

Adjuvant chemotherapy in the treatment of soft-tissue sarcoma.

Integration of limb-sparing surgery, brachytherapy, and external-beam irradiation in the treatment of soft-tissue sarcomas.

Management of extremity soft-tissue sarcomas.

Vascularized tissue transfer for closure of irradiated wounds after soft tissue sarcoma resection.

Perspectives on anthracyclines plus ifosfamide in advanced soft tissue sarcomas.

Comparison of amputation with limb-sparing operations for adult soft tissue sarcoma of the extremity [see comments].

Metastasis-free survival after local recurrence of soft-tissue sarcoma.

The role of multimodality therapy in soft-tissue sarcoma.

Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients.

Vascularized tissue transfer for closure of irradiated wounds after soft tissue sarcoma resection.

Prosthetic and extremity survivorship after limb salvage for sarcoma. How long do the reconstructions last?

Dermatofibrosarcoma protuberans of the chest and the shoulder: wide and deep excisions with immediate reconstruction.

The management of soft-tissue sarcomas of the extremities.

A comparison of the prognoses for deep and subcutaneous sarcomas of the extremities.

Tumors Masquerading as Hematomas.



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Thursday, August 13, 2015 6:39 am