What Does This Following Lab Report Indicate?

Posted on Thu, 18 May 2017

Question: 2.5x0.5x0.6cm complex hypo and hyper echoic ovoid non painful non compressible solid mass within the subcutaneous soft tissues with peripheral blood flow in the perianal area. There is abutment of the pelvic floor musculature no extension into the pelvis is appreciated. What are my differential diagnoses?

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
Tumor

Detailed Answer:
Hi
Thanks for your query.

Given a complex mass without pain and compressibility, it can be classified as a tumor. There are various differentials for tumor in that area. Benign tumors, like neurofibroma, schwannoma, hemangioma or malignant tumor like sarcoma. Other possibility is a complicated cyst. Basically a cyst which had infection and now resolving, or had bleeding inside it.

I think we need a biopsy here. Also further imaging like MRI of pelvis may be required before definitive treatment like surgery.

Hope this helps. I will be available for further follow up.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Indranil Ghosh (9 hours later)

obviously not a hemangioma. probability of neurofibroma or schwannoma are minimal. if it is a sarcoma, what are general rates of benign vs. malignant? I work in the medical field and am way too knowledgeable. Makes it too easy to become over-excited and terrified. I still have 2weeks before my appointment to even schedule a biopsy. How important is this time frame right now?

Answered by Dr. Indranil Ghosh (1 hour later)

Brief Answer:
couple of weeks should be fine

Detailed Answer:
Sarcoma by definition is malignant. Benign soft tissue tumors are lipoma, neurofibroma, schwannoma, etc. Among soft tissue tumors in that area which are quite well defined, benign vs malignant is like 50-50.

I feel that 2 weeks is ok before a biopsy but of course earlier is better.

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Above answer was peer-reviewed by : Dr. Remy Koshy