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December 2018

Two similar looking soft tissue tumors. What would you do and is one of them malignant
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Clinical information

Two patients, one slightly elderly male and one female examined for SONOZORG a primary care ultrasound facility. Both with palpable lesions. Which one is benign and which one malignant?

Ultrasound Images & Clips

two similar looking soft tissue tumors

The first patient has two lesions this is the largest one
The first patient has two lesions this is the largest one
This is the second lesion of the first patient
This is the second lesion of the first patient
Another image of both lesions
Another image of both lesions
The lesions are vascularized
The lesions are vascularized
The other lesion of the first patient is also vascularized
The other lesion of the first patient is also vascularized
This is the lesion of the second patient
This is the lesion of the second patient
Transverse image of the lesion of the second patient
Transverse image of the lesion of the second patient
This lesion is also vascularized
This lesion is also vascularized
Transverse image
Transverse image
This is another example of the same type of lesion in a second patient
This is another example of the same type of lesion in a second patient
And this lesion is also vascularized
And this lesion is also vascularized

Conclusion

The lesions of the first patient proved to be a malignant myxofibrosarcoma and the lesion of the second patient proved to be a benign nodular fasciitis.
Both lesions have unsharp borders and so we could not exclude malignancy. If you look at the location of the nodular fasciitis perhaps that could have helped you in the differential diagnosis.
But both patients were referred for biopsy and further treatment.

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photo Taco Geertsma
Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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