Step 2: Perform an Examination

Objective :

Identify a lesion as being suspicious for a soft tissue sarcoma

Tip 1
Mass

Look: You notice a 10 cm mass at posterior aspect of right thigh.

Feel: The mass is firm and non-tender.

Move: Mass is less mobile when the hamstrings are contracted, confirming it is deep to the fascia.

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Tip 1
Neck/Groin

Lymph Node examination is normal. Some soft tissue sarcomas spread by the lymphatics, so it is important to check them.

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Tip 1
Ankle/Foot

This patient has normal pulses and neurology in the foot. With such a big mass compression of the sciatic nerve can occur.

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More Info Next Step

It is important to determine if lesion is deep or superficial, usually by having the patient contract the underlying muscle. If contracting the muscle ‘fixes’ the lesion then it is likely deep. Deep lesions are much more likely to be sarcomas and need urgent referral.