Meeting Abstract

JL518. Mistaken Identity: The Soft Tissue Sarcoma Conundrum

Allison Lock, MPAS, PA-C, The University of Texas MD Anderson Cancer Center, Houston, Texas

ABSTRACT

Abstracts From  JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017

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Introduction: Soft tissue sarcoma (STS) is a cancer of connective tissues and can occur anywhere in the body. Approximately 13,000 new cases are diagnosed in the US each year and about 5,000 annual deaths are attributed to this disease. With over 70 subtypes comprising about 1% of adult cancers, STS is considered rare. Coupled with its rarity and propensity to mimic benign etiologies, accurate diagnosis can be challenging and mismanagement is common. STS prognosis is largely contingent upon its initial management. NCCN Guidelines advise a multidisciplinary approach to management for improved clinical outcomes.

Purpose: (1) Highlight cases of STS with initial suspicion of benign etiologies; (2) Discuss the importance of considering STS in the differential diagnosis when evaluating a soft tissue mass; (3) Review NCCN Guidelines for STS management.

Description: A 60-year-old female presents to her gynecologist for evaluation of a left labial “knot.” It is initially diagnosed as a sebaceous cyst. A 46-year-old female presents to her PCP for evaluation of a self-palpated painless, rubbery abdominal wall mass. Initial diagnosis is lipoma. A 58-year-old male presents to a general surgeon due to multiple recurrent fat containing inguinal hernias. This case series is presented to discuss commonly encountered scenarios of mistaken identities in soft tissue sarcoma. Each case will be discussed from initial presentation and diagnosis through eventual referral to a tertiary care center for diagnostic confirmation and management. Next, data is presented to support the idea that initial treatment of soft tissue sarcomas is critical to prognosis. Further, NCCN Guideline–derived strategies for more accurate primary diagnosis and management will be suggested.

Discussion: From sebaceous cysts, to lipomas, and hernias, STS is frequently mistaken for benign etiologies on initial presentation. Each case exemplifies a common clinical scenario that may be encountered in any specialty. It is important for APPs to recognize STS as a potential item on the differential diagnosis, as mismanagement may result in poor clinical outcomes.

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