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Small indeterminate superficial soft tissue masses: relationship between depth and histological grade
Michael Khoo1, Ian Pressney1, Craig Gerrand2
1Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK.
The British Journal of Radiology
|February 29, 2020
Summary
The depth of small soft tissue masses in the subcutaneous tissue may indicate their aggressiveness. Deeper lesions are more likely to be intermediate-grade or malignant, suggesting wider excision margins may be needed.
Area of Science:
- Oncology
- Pathology
- Radiology
Background:
- Small, indeterminate soft tissue masses require accurate diagnosis.
- Subcutaneous lesions pose diagnostic challenges, especially when evaluated by MRI.
- Histological grade is crucial for determining appropriate treatment and prognosis.
Purpose of the Study:
- To investigate the relationship between the anatomical location (depth) of small, indeterminate soft tissue masses within the subcutaneous compartment and their histological grade.
- To determine if lesion depth can predict malignancy or intermediate-grade histology.
Main Methods:
- Retrospective analysis of 43 patients with small (<3 cm) superficial soft tissue masses referred to a Sarcoma Service over 12 months.
- Lesions were categorized by anatomical depth within the subcutaneous compartment (superficial, central, deep).
- Histopathological diagnoses were classified using the 2013 WHO classification; statistical analysis (chi-squared) assessed the relationship between depth and grade.
Main Results:
- Of 43 lesions, 16 were superficial, 9 central, and 18 deep. Histology revealed 9 non-neoplastic, 29 benign, 1 intermediate-grade, and 4 malignant.
- Lesions located in the deep aspect of the subcutaneous compartment showed a statistically significant association with intermediate or malignant histology (p=0.02).
Conclusions:
- The anatomical depth of small, indeterminate subcutaneous soft tissue masses may serve as an indicator of histological aggressiveness.
- Deeper lesions within the subcutaneous tissue are more frequently associated with intermediate-grade or malignant tumors.
- Consideration of wider surgical margins during excision biopsy may be warranted for deep-seated lesions to ensure complete tumor removal.
