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Diagnosis and Management of Subcutaneous Soft Tissue Sarcoma

  • Skin Cancer (T Ito, Section Editor)
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Opinion statement

The proper diagnosis and treatment planning for subcutaneous soft tissue sarcoma is very important. Soft tissue tumors can occur anywhere in the body, but if they occur subcutaneously, patients can easily notice a subcutaneous soft tissue mass. Therefore, it is possible to determine through recording, the growth speed of the mass, which is often difficult to obtain with deep-situated soft tissue masses. Palpation can also provide information about the firmness and mobility of the mass. Thus, history taking and physical examinations are informative for subcutaneous soft tissue tumors, compared to tumors that occur deeply. Because subcutaneous soft tissue tumors are easily recognized, they are often resected, without sufficient imaging analyses or thorough treatment planning. An operation performed based on such an inadequate preoperative plan is called a “whoops surgery.” In the case of “whoops surgeries,” subsequent radical surgery is required to remove additional areas, including hematomas that result from the initial surgery, that require a wider range of resection and soft tissue reconstruction. Therefore, as with deep-seated soft tissue tumors, it is important to conduct careful imaging examinations and make appropriate preoperative plans for subcutaneous soft tissue tumors. Subcutaneous soft tissue sarcomas often show an invasive pattern, and such tumors require a more careful assessment to prevent local recurrence after surgery. During surgery, it is necessary to remove the entire infiltration area along the fascia. Sometimes, an adequately wide excision is necessary, which is considered the minimum necessary procedure to eradicate the lesion. As noted above, clinicians who see patients with subcutaneous soft tissue tumors are encouraged to have sufficient knowledge and experience regarding the diagnosis and treatment. This article is intended for all doctors who deal with subcutaneous soft tissue tumors and focuses on essential points regarding their diagnosis and management.

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Funding

This work was supported in part by Grants-in-Aid for Young Scientists (18K16627) from the Japan Society for the Promotion of Science and a Grant from Japan Orthopaedics and Traumatology Research Foundation Inc. (no. 332).

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Makoto Endo MD, PhD., Nokitaka Setsu MD, PhD., Toshifumi Fujiwara MD, PhD., Takeaki Ishii MD., Makoto Nakagawa MD, PhD., Kenichiro Yahiro MD., Atsushi Kimura MD., Eijiro Shimada MD., Yasuharu Nakashima MD, PhD. & Yoshihiro Matsumoto MD, PhD.

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  1. Makoto Endo MD, PhD.
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  2. Nokitaka Setsu MD, PhD.
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  6. Kenichiro Yahiro MD.
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Correspondence to Makoto Endo MD, PhD..

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Makoto Endo has received compensation from Taisho Toyama Pharmaceutical Co., Ltd., Daiichi Sankyo, Eli Lilly and Company, Eisai, and Novartis for service as a consultant or a speaker.

Nokitaka Setsu declares that he has no conflict of interest.

Toshifumi Fujiwara declares that he has no conflict of interest.

Takeaki Ishii declares that he has no conflict of interest.

Makoto Nakagawa declares that he has no conflict of interest.

Kenichiro Yahiro declares that he has no conflict of interest.

Atsushi Kimura declares that he has no conflict of interest.

Eijiro Shimada declares that he has no conflict of interest.

Yasuharu Nakashima has received research funding from Kyocera and Eisai, and has received speaker’s honoraria from Zimmer Biomet, Chugai Pharmaceutical, Mitsubishi Tanabe Pharma, Janssen Pharmaceuticals, Eisai, AbbVie, Bristol-Myers Squibb, Astellas, Hisamitsu Pharmaceutical Co., Inc., and Taisho Toyama Pharmaceutical Co., Ltd.

Yoshihiro Matsumoto declares that he has no conflict of interest.

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This article is part of the Topical Collection on Skin Cancer

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Endo, M., Setsu, N., Fujiwara, T. et al. Diagnosis and Management of Subcutaneous Soft Tissue Sarcoma. Curr. Treat. Options in Oncol. 20, 54 (2019). https://doi.org/10.1007/s11864-019-0656-z

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