Clinicopathological study and management of peripheral soft tissue tumours

Soft-tissue tumours comprise a large heterogeneous group of mesenchymal neoplasms that is classified according to their normal tissue counterpart. They are ubiquitous in nature and can pose a challenge in terms of diagnosis and therefore, in their management. Biopsy findings bear direct implications on the treatment outcomes. The current study was conducted to understand various modes of clinical presentation, diagnostic modalities and to correlate them with operative findings, to delineate the different treatment modalities for patients with soft tissue tumours. We also assessed the risk factors and complications associated with soft tissue tumours. This was a prospective study conducted at a rural teaching hospital in India. Accurate history was elicited from patients with peripheral soft tissue tumours and a thorough physical examination was done. The patient demographics were noted. The clinical parameters assessed included location and size of swelling, any associated pain, neurovascular symptoms, presence of any deformity and medical risk factors. To diagnose the type of swelling, biopsy was done. All swellings were excised, and based on the diagnosis, additional therapeutic measures were employed. Post-operative complications and hospital stay were recorded. A total of 74 patients were included in the study, with male to female ratio of 1:1 and average age of 37.96 years. All of them presented with a swelling. The lower extremities and trunk were the most common sites, with each comprising about 25%. The size of tumour varied from 2 to 10 cm in diameter. Seventy one were benign and three were malignant. About one third of patients complained of pain. Comorbid illnesses were present in three patients. For benign tumours, simple excision was done, while for the malignant ones, multimodal therapeutic approach was taken. Post-operatively, two patients developed skin ulceration over the tumour, and six had wound infection. Most soft tissue tumours encountered in clinical practice are benign, of which lipoma is the commonest. While simple excision suffices for most benign tumours, a more aggressive treatment approach is required for their malignant counterparts.