Benign lesion (Nevi, pilomatrixoma, lipoma, dermoid, epidermoid cyst) Flashcards

1
Q

Classification of soft tissue lesions?

A

Cystic vs Solid followed by tissue origin:

Solid:

  • Epidermal/Adnexal
  • peripheral nerve
  • Fibrous tissue (fibroblastic, myofibroblastic, fibrohystiocytic)
  • Smooth muscle
  • Skeletal muscle
  • Pericytic
  • condro-osseous
  • adipose
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2
Q

Common cystic soft tissue lesions?

A

Dermoid, epidermal, trichilemmal, synovial, ganglion.

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3
Q

Epidermal/Soft tissue solid lesions?

A

1) pyogenic granuloma
2) pilomatrixoma
3) verruca vulgaris

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4
Q

Peripheral nerve masses?

A

1) Fibrolipomatous hamartoma of nerve
2) Schwannoma
3) neurofibromas
4) neurothecoma
5) granular cell tumor

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5
Q

Fibrous tissue masses?

A

1) Nodularfasciitis
2) Fibrous hamartoma of infancy
3) Myofibroma
4) benign fibrous histiocytoma
5) Juvenile xanthogranuloma

Many others…

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6
Q

Smooth muscle masses?

A

1) Leiomyoma

2) angioleiomyoma

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7
Q

Skeletal muscle masses?

A

Rhabdomyoma

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8
Q

Pericytic (perivascular) masses?

A

Glomus tumor

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9
Q

Chondro-osseous masses?

A

Chondromas

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10
Q

Adipose tissue masses?

A

Lipoma

Lipoblastoma

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11
Q

General imaging of soft tissue masses?

A

Plain X-ray: for diagnosis of calcifying lesions or chondro-osseous lesions. Gives information on bony erosion/invasion.

U/S: Good for superficial lesions to differentiate solid vs cystic. Also good for vascular lesions with Doppler.

MRI: Gold standard for most soft tissue lesions. Gives best information on surrounding structures when planning resection.

CT: Rarely indicated.

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12
Q

Epidermal cysts management?

A

Respect due to risk of infection, contain ectodermal elements only.

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13
Q

Dermoid cysts management?

A

Contain dermal and ectodermal elements.

Should be removed as they will continue to increase in size. Angular Dermoids can be disfiguring if left.

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14
Q

Pilomatrixoma management?

A

Found in the head & neck, and upper extremity.
Case reports of malignancy
Resect electively

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15
Q

Nodular Fasciitis management?

A

Proliferation of fibroblasts/myofibroblasts- usually superficial but may occur in muscles.
Grow rapidly in the H&N, trunk, arms.

Excise electively- rarely recur

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16
Q

Fibrous hamartoma of infancy management?

A

Benign tumor occurs in the first 2 years of life, 1/4 congenital.
Occurs in shoulder, axilla, and upper arm.

Excise completely or risk local recurrence.

17
Q

Myofibroma management?

A

Multi centric or generalized lesions present at birth- may affect organs but most commonly affect skin, bone. Generalized in often fatal.

Solitary - occurs later in childhood.

Multi centric and solitary grow through the first year and then regress.

Excision for form/function.

18
Q

Lipoblastoma management?

A

Occurs as encapsulated lipoblastoma or lipoblastomatosis.

PLAG1 gene hybrid molecular testing for diagnosis.

Treat with excision. 1/5 reoccur due to incomplete excision - especially lipoblastomatosis which can grow between muscular planes.

19
Q

Neurofibroma management?

A

Occurs as sporadic solitary lesions or multiple in NF-1
They are peripheral nerve sheath tumours.

Remove if symptomatic

20
Q

Ganglion/synovial cysts?

A

Occurs near joint spaces

Ganglion most common in wrists - generally observe due to high recurrence

Synovial most common near knee