Non-neoplastic soft tissue masses may mimic soft tissue sarcoma in a wide variety of clinical settings. Systematic and thorough review of patient history, physical examination, imaging, laboratory results, and biopsy will allow the clinician to differentiate between the two in most cases. We describe several common non-neoplastic entities that may mimic soft tissue sarcoma in case presentation format along with the characteristics that help distinguish them.
Key points
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Atypical features of soft tissue sarcoma that may be more common in benign imitators include small size, superficial location, soft consistency, painful character, inflammatory or homogeneous signal on axial imaging, or irregular shape.
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Heterogeneous cystic necrosis of a soft tissue mass is an ominous sign and may indicate a malignant neoplastic process.
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Plain radiographs are a valuable adjunct to the evaluation of any soft tissue mass.
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When other diagnostic modalities fail, core needle biopsy at the treating institution is the gold standard for diagnosis.
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The diagnosis should be pursued with repeat needle or open biopsy if initial needle biopsy is unsuccessful.
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