The Journal of Bone and Joint Surgery, Vol 69, Issue 1 100-105, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Ultrasound imaging as a screening study for malignant soft-tissue tumors
TA Lange, CW Austin, JJ Seibert, TL Angtuaco and DR Yandow
Fifty patients who had a palpable soft-tissue mass and an apparently normal
radiograph were studied with ultrasound imaging before excision or biopsy
of the lesion was done. As shown by the sonograms, thirty-five lesions had
a discrete echo pattern (usually reduced echoes and a clearly defined
lesional margin) and fifteen had an ill defined pattern (similar to the
pattern of the surrounding normal tissues with no definable lesional
margin). Fourteen lesions were malignant and thirty-six, benign. The
sonograms of all fourteen malignant lesions showed a discrete pattern,
while the sonograms of the benign ones showed twenty-one discrete and
fifteen ill defined patterns. Therefore, the malignant lesions produced a
discrete pattern in every instance, and every lesion that produced an ill
defined pattern was benign. Fourteen of the fifty lesions were cystic; of
these, thirteen were benign and one was malignant. The sonograms correctly
identified the cyst in seven of the thirteen benign lesions and in the one
malignant cystic lesion. Based on these findings, we concluded that all
palpable soft-tissue masses that appear to be discrete on a sonogram should
be diagnosed without delay by examination of a specimen taken at biopsy,
whereas lesions that have an ill defined appearance on a sonogram may be
assumed to be benign and may safely be observed in selected patients.
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