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Case 272.

Gokhan Kuyumcu1, Yaxia Zhang1, Hakan Ilaslan1

  • 1From the Imaging Institute (G.K., H.I.) and Robert J. Tomsich Pathology and Laboratory Medicine Institute (Y.Z.), Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44106.

Radiology
|July 19, 2019
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Summary
This summary is machine-generated.

A 92-year-old woman presented with a hip mass and pneumonia. Imaging revealed a large, painful mass, initially concerning for malignancy, but ultimately diagnosed as a rare soft tissue tumor. This case highlights the importance of comprehensive imaging in elderly patients with complex presentations.

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Area of Science:

  • Oncology
  • Radiology
  • Geriatrics

Background:

  • Elderly, bedridden patients can present with complex symptoms.
  • A large, hard, fixed mass in the thigh of an elderly patient warrants thorough investigation.
  • History of lymphoma requires consideration of recurrence or secondary malignancy.

Purpose of the Study:

  • To present a case of a large soft tissue mass in an elderly patient.
  • To discuss the diagnostic challenges and imaging modalities used.
  • To highlight a rare soft tissue tumor diagnosis in a geriatric patient.

Main Methods:

  • Clinical presentation and physical examination.
  • Laboratory investigations including complete blood count.
  • Imaging studies: chest radiography, abdominal/pelvic CT, lower extremity CT, ultrasound (US), and Doppler US.
  • Exclusion of magnetic resonance imaging (MRI) due to pacemaker.

Main Results:

  • A 92-year-old bedridden female presented with fever, cough, and a right lateral hip mass.
  • Imaging revealed a large (5x5x10 cm) painful, hard, fixed mass.
  • CT and US demonstrated a soft tissue mass without evidence of lymphadenopathy or bone involvement. Pneumonia was diagnosed and treated concurrently.

Conclusions:

  • Large soft tissue masses in the elderly can be challenging to diagnose.
  • A combination of imaging techniques is crucial when MRI is contraindicated.
  • This case underscores the importance of considering rare soft tissue tumors in the differential diagnosis of geriatric patients with unexplained masses.