Lower extremity mass.

KEY CLINICAL MESSAGE: Soft tissue sarcomas are rare tumors accounting for less than 1% of all malignancies. Multidisciplinary approach is used in the management of these patients.

Question

A 70-year old male presents with a left lower extremity mass, which has been increasing in size and causing him discomfort. What does this patient have and how do you manage this condition? (Fig.1)

Figure 1

Lower extremity sarcoma.

Answer – This patient has soft tissue sarcoma. These sarcomas most commonly occur in adults and about half of them are found on extremities. Most of these patients are asymptomatic. Magnetic resonance imaging (MRI) is the primary imaging method for soft tissue sarcomas. Suspicious lesions should undergo needle or open biopsy for tissue diagnosis. Surgical resection with wide margin is the mainstay of the treatment. Chemotherapy and radiation therapy are used as adjunct therapy [1,2].