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Done CT Scan For Sarcoma. Diagnosed As Lipoma. Chances Of Malignancy?

Posted on Wed, 20 Jun 2012

Question: I just had a CT scan of a lipoma in my thigh. The docs thought it was a sarcoma in my muscle because it is so XXXXXXX and so large... complex mass, part solid and part cystic 8.6 x 5.6 x 4.3. Would you suggest removing this and is there any chance it could turn malignant?

Answered by Dr. Indranil Ghosh (1 hour later)

Hi XXXXXXX

Thank you for posting your query.

You have mentioned that the doctors thought it was a sarcoma. Was biopsy done and did it confirm it to be a lipoma?

I am afraid that the features you have just mentioned are more suggestive of a malignancy (sarcoma) rather than a lipoma (benign).

In case it is a sarcoma, the best bet would be to go for a needle biopsy followed by surgery to get rid of it. Other option would be to go for immediate surgery and do an intra-operative biopsy to confirm the diagnosis. It is a complex surgery and should be done by surgeons specializing in soft tissue surgeries.

You may also need a chest CT scan for staging.

Treatment after surgery may involve radiation with or without chemotherapy to decrease the chances of it coming back. Choice of treatment depends upon the exact pathological features.

You have significant co-existing illnesses but as long as they are under control, you should not have a problem in getting anesthetic clearance.

However, if it is truly a lipoma then chances of it turning malignant are extremely low.

I am confident that timely surgery would cure you completely even if it is a sarcoma.

Hope I have answered your query. Please do write back if you have any further queries.

Wishing you a speedy recovery.

Regards.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Indranil Ghosh (1 hour later)

I had an ultrasound that implicated sarcoma and then a CT scan that said it was a lipoma, Is a CT scan definative or should I still have the biopsy?

Answered by Dr. Indranil Ghosh (10 hours later)

Thanks for reverting.

Going by the features you had mentioned I would still recommend a biopsy. But if your radiologist and oncologist both feel that the features are totally benign then you may wait it out also.

Regards,

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Above answer was peer-reviewed by : Dr. Shanthi.E