Benign soft tissue tumor

Definition

Benign soft tissue tumors are non-cancerous growths that form in soft tissues throughout the body, including muscles, tendons, adipose tissue, etc. 

The following types of benign growths are distinguished:

• lipomas;
• fibromas;
• angiolipomas;
• benign fibrous histiocytomas;
• neurofibromas;
• schwannomas;
• hemangiomas;
• tendon cell tumors;
• myxomas.

Benign soft tissue lesions rarely metastasize but are often large and deep. However, some masses behave very aggressively. Diagnosed invasion of nearby tissue increases the chance of incomplete removal and the possibility that the tumor will return.

The most common benign soft tissue tumor in adults is lipoma, and in children, it is Baker’s cyst. Lipoma and hemangioma are most commonly seen in both adults and children.

Symptoms

In most cases, benign skin tumors develop painlessly in the form of single or multiple nodules or growths. More often, they are localized in the upper extremities, chest, and face. In most cases, neoplasms are covered with skin of standard color, less often pink. There are formations with different colors, from yellowish-brown to black-blue.

The most frequent symptom is a sudden palpable tumor; in second place are various kinds of painful sensations preceding the appearance of the tumor, and in third place – the appearance of a painful tumor.

The character of pain sensations, as a rule, is moderate and inconstant; it doesn’t have the same intensity as in primary bone tumors and most often manifest themselves during functional loads or palpation of the tumor. When the tumor grows into the bone, the pain becomes constant, and neuritis or plexitis may develop when localized in the area of large nerve trunks.

Types of benign neoplasms

Fibroma

It comes from fibrous connective tissue and can occur wherever the latter occurs. A distinction is made between hard fibromas, represented by a nodule with a dense consistency, and soft fibromas, characterized by a flabby consistency. The favorite localization of soft fibromas, usually growing on a stalk, is the subcutaneous tissue of the genitals and anal area. Fibromas grow extremely slowly, are demarcated from the surrounding tissues, and are mobile.

Lipoma

It is formed from fatty tissue. It is most often located in the subcutaneous tissue but can be located in any part of the body where there is fatty tissue (for example, in the retroperitoneum). In women, lipomas are noted 3-4 times more often than in men; age does not matter. Sometimes there are multiple lipomas (lipomatosis). A lobular structure and soft consistency often characterize the tumor. It is not adherent to the skin and is mobile in relation to the surrounding tissues. Lipoma growth is slow. Its size is different, sometimes quite significant. If there is a large amount of connective tissue in the lipoma, the tumor is attributed to fibrolipoma. However, this diagnosis is made mainly after histological examination.

Myoma

It develops from muscle tissue and can be localized in any body area with muscle tissue. Tumors from transverse striated muscle are called rhabdomyomas, and those from smooth muscle are called leiomyomas. Rhabdomyomas are primarily found in soft tissue, usually located on the extremities. The disease is observed equally often in persons of both sexes and usually occurs at a young age. Tumors grow slowly, have a dense elastic consistency, are mobile, delimited from the surrounding tissues, and are painless. Since myomas are located in the thickness of the muscle and do not cause patients anxiety, they are usually quite large, and by the time the patient turns to the doctor, they are usually quite large.

Hemangioma

Hemangiomas are tumors originating from blood vessels. They are most often noted in children and young adults. Depending on the localization, the following groups of hemangiomas are distinguished: mainly skin, the musculoskeletal system as a whole, and parenchymatous organs. In soft tissues, the most common are cavernous, racemose, and intermuscular hemangiomas. They are formed mainly in the subcutaneous tissue and muscles of the lower extremities.

The clinical picture of hemangioma is characterized by two main signs: pain and the presence of swelling (tumor). Its consistency is soft or dense-elastic. The dense consistency is usually found with relatively few functioning vessels in the tumor. If there are a large number of functioning vascular cavities, the consistency of the hemangioma is soft. If the tumor is associated with a large arterial vessel, it may pulsate, in which case a vascular murmur can be detected above it.

The color of the skin over the tumor varies and depends on the depth and growth of the hemangioma. If the tumor is located deep in the muscle tissues and continues to grow towards the bones of the limb, the color of the skin over it may not change. With a shallow localization of the tumor and its growth into the subcutaneous tissue, the color of the skin may change from bluish to bright purple. When squeezing, such a tumor decreases in size, and the color of the skin becomes less intense. As a rule, pain in hemangioma indicates a far-reaching pathological process affecting the extremities’ deep muscle tissues and nerves.

Glomus tumor (Barré-Masson tumor).

It occurs most often in childhood and middle age, predominantly in males. The favorite localization of the tumor is the nail phalanges. In most cases, the glomus tumor is solitary, but sometimes, several may be in one area. The leading symptom is a sharp burning pain when pressing on the tissue in which the tumor is located. Clinically, a glomus tumor becomes visible quite a long time after the onset of pain. It is usually round, elastic, and 1 to 3 cm in diameter. The skin over the tumor is often livid.

Tenosynovial giant cell tumor

This tumor is usually found in areas where there is a synovial sheath. It is noted between the ages of 30-50 and is more common in women. In most cases, the giant-cell tumor is located on the upper extremities in the area of tendon sheaths of the hand, less often – on the hand itself, the foot, near the wrist, and ankle joints. Tenosynovial giant cell tumor grows slowly as a lumpy round or oval nodule of moderately dense consistency delimited from the surrounding tissues. Sometimes, it consists of several nodules with a single fibrous capsule. Occasionally, the tumor is associated with the skin.

Neurinoma

It arises from Schwann cells of the nerve sheath. It is localized along the course of nerve trunks. It occurs at any age. It affects mainly the upper extremities, neck, and head. The tumor can be single or multiple, growing slowly in the form of a clearly delineated node. The size of a neurinoma ranges from a few millimeters to 3-4 cm in diameter. The tumor has a dense consistency. One of the characteristic signs is painfulness when pressing.

Neurofibroma

Develops from the sheaths of nerves. It is observed in men and women of any age. It is most often localized in the area of intercostal and sciatic nerves. Neurofibromas are predominantly single nodules, but multiple neurofibromatosis, known as Recklinghausen’s disease, can also occur. Neurofibromas grow slowly and have a rounded shape, smooth surface, and dense-elastic consistency. Pressing on the tumor causes pain along the course of the nerve. The size of neurofibromas can vary, sometimes reaching 15-20 cm in diameter.

Diagnosis and treatment

The main diagnostic methods are biopsy, physical examination, and ultrasonography. Most benign neoplasms are subject to surgical treatment and removal. The main indications for surgery for benign soft tissue tumors are an increase in the size of the neoplasm, chronic traumatization, and a high risk of malignization.

The main methods of treatment:

• surgical removal (resection, scalpel excision);
• laser removal;
• cryotherapy (use of liquid nitrogen).

A combination of methods may be used. Healing takes about two weeks, depending on the location and damage to other tissue types.

All these treatment options are available in more than 750 hospitals worldwide (https://doctor.global/results/diseases/benign-soft-tissue-tumor). For example, Soft tissue tumor removal can be done in 23 clinics across Turkey for an approximate price of $3.9 K (https://doctor.global/results/asia/turkey/all-cities/all-specializations/procedures/soft-tissue-tumor-removal).