Pitfalls in ultrasonography of soft tissue tumors

Ultrasonography is increasingly the first-line investigation for the assessment of soft tissue masses. With increasing experience, most soft tissues masses, particularly superficial soft tissue masses, can be specifically labeled based on their ultrasonographic appearances. This diagnosis is based on a conundrum of clinical and ultrasonographic findings rather than resting on a single sign alone. One should try to minimize labeling the ultrasonographic appearances as "nonspecific" because this adds little to what is already known. Putting a specific label on a soft tissue mass such as a lipoma, nerve sheath tumor, or giant cell tumor of tendon sheath minimizes the need for percutaneous biopsy, greatly enhances clinical efficiency with regard to discussions on management and outcome, as well as immediately reduces patient anxiety with regard to the presence of malignancy. This article addresses the general approach to ultrasonography of soft issue masses, highlighting in particular the common pitfalls encountered in their diagnosis.