Soft tissue tumors

Soft tissue tumors are divided into two major groups:

• benign tumors
• malignancies

The vast majority of benign tumors are benign because they do not metastasize. However, some types of benign tumors may have an aggressive growth path involving the surrounding structures. There are different types of tumors in this group of tumors. The most common tumors are lipomas, angiolipomas, fibroids, benign fibro cysts, neurofibromas, schwannomas, hemangiomas, glandular tendon tumors, and myxomas.

The most common benign tumor is a lipoma. Lipoma is a soft, slow-growing, painless formation of adipose tissue that is most commonly localized under the skin. In rare cases, the lipoma can be localized to a variety of sites that are sometimes difficult to reach surgically. Although in most cases the patient is worried about lipoma for cosmetic reasons, they can only rarely cause functional impairment. In cases where the lipoma is growing rapidly and causing pain, the patient should be examined very carefully, as it is possible that a malignant process has begun.

In the case of benign tumors, ultrasonography is a sufficiently informative diagnostic method to assess the nature of the tumor. In cases where ultrasonography does not provide sufficient information, computed tomography or magnetic resonance imaging may be used. These tests help to obtain information about the size, structure, and relationship of the tumor to the surrounding tissues. The diagnosis is confirmed only by histological examination. In cases where the structure of the tumor is not clear, a puncture biopsy may be performed to select an appropriate surgical approach. This can be done under ultrasound control.

Benign tumors are treated surgically by cutting out the tumor. If the tumor is small in size and the diagnosis is clear, then tumor dynamics can be observed. Generally, if adequate surgical treatment is performed, the treatment of benign tumors provides very good cure rates. In rare cases, when the tumor progresses aggressively, recurrence may develop after surgery.

At the Latvian Microsurgery Center, it is possible to perform microsurgical excision of tumors under optical magnification, performing microscopic resection lines during the operation, as well as performing reconstructive and / or plastic surgery at the end stage of the operation, using local plastic options. If necessary, tissue transplantation from various other parts of the body can be performed in microsurgical technique.

Malignant soft tissue tumors are very rare. Soft tissue sarcoma is diagnosed in approximately 1% of all malignancies. Sarcomas can develop in the tissues that connect, support, include other body structures. More than 50 types of sarcomas have been described. Some types of sarcomas are more common in children, while the vast majority of sarcomas are diagnosed in adults. Although sarcomas can develop in a variety of parts of the body, sarcomas are most often diagnosed in the arms, legs, and abdomen.

Soft tissue sarcoma is often very difficult to diagnose. There are usually no complaints in the early stages, so diagnosis is a random finding. As the tumor grows, swelling may appear. If the tumor presses on nerves or blood vessels, pain may occur. Given that there are so many types of soft tissue sarcomas, it is very important to determine the exact type of sarcoma.

• X-rays
• Ultrasonography
• Computed tomography
• Magnetic resonance
• Positron emission tomography
• Biopsy

A biopsy is the most important examination method. Depending on the localization and size of the tumor, either a core needle biopsy (puncture) or a surgical biopsy can be performed when a sample of tumor tissue is taken during a small operation.

Treatment depends on the size, type, and location of the soft tissue tumor. The primary method is surgical treatment. Due to the aggressive nature of the tumor, the use of so-called compartment surgery is very important in soft tissue sarcomas. During the operation, the tumor is removed within the entire anatomical segment. Namely, if the tumor has grown into a muscle, then the tumor is removed within the entire anatomical space of the muscle. In practice, this means that much more tissue can be removed compared to the size of the tumor. Radiation therapy and chemotherapy are also used as adjunctive therapy.

At the Latvian Microsurgery Center, it is possible to perform microsurgical excision of tumors under optical magnification, performing microscopic resection lines during the operation, as well as performing reconstructive and / or plastic surgery at the end stage of the operation, using local plastic options. If necessary, tissue transplantation from various other parts of the body can be performed in microsurgical technique.