The differential diagnosis of trunk and extremity dermal and sub-dermal lesions referred to a musculoskeletal oncology service.
OBJECTIVES
To determine the differential diagnosis of dermal and sub-dermal soft tissue masses which do not extend to the deep fascia that are referred to a specialist musculoskeletal oncology service.


MATERIALS AND METHODS
Review of all patients referred to a specialist musculoskeletal oncology service over a 13-month period with a dermal or sub-dermal soft tissue mass which did not extend to the deep fascia based on MRI appearances. Data collected included age, gender, site and maximal lesion size, and final histological diagnosis for biopsied and/or excised lesions.


RESULTS
56 patients were included, 21 (37.5%) males and 35 (62.5%) females with mean age 49.75 years (range 5-86 years). 3 patients had 2 lesions making a total of 59 lesions, 11 (18.6%) dermal and 48 (81.4%) sub-dermal. Histological diagnosis was available in 44 (74.6%) cases, of which 11 (25%) were non-neoplastic, 23 (52.3%) were benign neoplasms, and 10 (22.7%) were malignant neoplasms. Although older age at presentation and greater mean maximal tumour dimension were seen with malignant lesions, these did not reach statistical significance (p = 0.154 and 0.102 respectively). There was also no relationship between skin involvement from sub-dermal lesions and malignancy, but 5 of 6 dermal lesions which showed an exophytic growth pattern were malignant.


CONCLUSIONS
The differential diagnosis of dermal and sub-dermal lesions which do not reach the deep fascia is wide with a malignant lesion being the cause in almost one-quarter of cases.
['Saifuddin|Asif|A|', 'Ali|Sania|S|', 'Sabahuddin|Ahmad|A|', 'Malhotra|Karan|K|', 'Khoo|Michael|M|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D002648:Child D002675:Child, Preschool D003937:Diagnosis, Differential D005121:Extremities D005260:Female D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D012509:Sarcoma D012983:Soft Tissue Neoplasms D055815:Young Adult
Differential diagnosis Sub-dermal Soft tissue mass MRI Superficial