What Does A Sarcoma Lump Look and Feel Like?

Blog Topic:
- Cancer Awareness

Within this article we'll provide you with information to help you discern whether a new or existing lump is cause for concern of sarcoma and, if so, what steps you should take next. If there's any uncertainty, see your primary care doctor.

What is Sarcoma?

A sarcoma is a type of cancer that develops in bone or soft tissues like muscle, nerves, fat, fibrous tissues, tendons, or blood vessels. Sarcomas can grow anywhere in the body, but they most often appear as a lump or bump on the arms and legs. Bone sarcomas can be more difficult to detect.

While sarcoma can be a deadly disease, the good news is that it's also very rare. The American Cancer Society estimates about 13,190 new soft tissue sarcomas will be diagnosed in the United States this year. For comparison, more than 265,000 cases of breast cancer and nearly 270,000 cases of prostate cancer will be diagnosed over the same period.

Signs and Symptoms of Sarcoma

Early detection is key to diagnosing and treating sarcoma. There are four qualities that can help you determine whether a new or existing lump is potentially a sarcoma:

1. Location

The majority of sarcomas develop in the arms and legs – at the upper ends of the limbs, specifically. They can also develop in the buttocks, chest wall, pelvis, and head and neck areas. "Sarcomas can grow to be big, deep masses in the upper part of the extremity, just below the buttocks, in the thigh, or in the upper arm," says Kristy L. Weber, MD, Director of the Penn Medicine Sarcoma Program at the Abramson Cancer Center.

On the other hand, sarcomas are less likely to develop in the fingers and feet. Dr. Weber notes that these sites shouldn't be dismissed entirely, but she estimates that less than one percent of these nodules turn out to be a sarcoma.

Fingers and feet are common sites of cysts or other benign (noncancerous) soft tissue lumps. One of the most common soft tissue masses in the hands and feet is a superficial or intramuscular lipoma, which is a slow-growing, benign fatty lump. Typically, a lipoma feels doughy, not tender, and can move around when a slight bit of pressure is applied to it.

2. Rate of Growth

If your lump has visibly grown, especially relatively rapidly, Dr. Weber recommends getting it evaluated. And anything that's progressed to the size of a golf ball requires immediate attention.

On the other hand, if it's remained about the same size over a few weeks to months, it's most likely not a sarcoma. A medical evaluation can determine its nature. Depending on the size and location of the mass, an MRI or ultrasound will be used.

3. Pain

The vast majority of soft tissue sarcomas do not cause pain, which, unfortunately, leads people to mistakenly think they don't need an evaluation.

When a sarcoma is deep-seated, growing quickly, and located near sensitive areas like the sciatic nerve, it may be painful. A sarcoma that starts in a bone is also going to cause pain, among other symptoms.

4. Firmness

Firmness could also be an indication that your lump is more than a fatty deposit. If your lump is soft and easy to move around, it may be less concerning from a sarcoma perspective, but Dr. Weber recommends keeping an eye on it just to be sure.

What To Do If You Think You Might Have Sarcoma

These characteristics are meant to heighten your awareness of sarcoma, but it's important not to put too much weight on any one of them. If you believe that your lump warrants a closer look by a professional, they'll use these same benchmarks in their initial assessment.

Start with your primary care doctor. They'll conduct a physical exam and take a thorough look at your medical history to determine whether to order an MRI with contrast dye or ultrasound of your lump.

If the imaging shows the lump to be definitely benign, Dr. Weber says it can be observed over time.

If the imaging indicates a concern, or the results are inconclusive, your next appointment should be with a specialist like Dr. Weber. They'll review your imaging and history and conduct their own exam to determine whether your lump should be monitored over time or biopsied.

Expertise Is Critical

Because sarcoma is so rare, diagnosing and treating it requires a deep knowledge of the disease. Over the years, Dr. Weber has cared for a number of patients who had lumps removed by surgeons who did not specialize in sarcomas. Sometimes in these instances, the initial surgery was performed without any prior imaging or a needle biopsy. Removing a sarcoma without getting a wide margin of normal tissue around the tumor means that cancerous cells are likely left in the surgical area. In this situation, a second surgery, usually coupled with radiation, is required to ensure all the tumor cells are removed.

"The bottom line is, you want to get a sarcoma removed correctly the first time, by an expert who specializes in sarcoma care," Dr. Weber says.

Because of its difficulty to diagnose, the expertise of your sarcoma care team should extend beyond the surgeon, she says.

"In general, for both radiologists and pathologists that don't see sarcomas all the time, the risk of making a mistake is higher because they aren't seeing them every day," Dr. Weber says. "The key thing is, we want to make sure it is a sarcoma. Deciding whether it is or isn't is critical. And unless you're a radiologist or pathologist that does this a lot, differentiating a benign tumor from a malignant one can be hard."

Further complicating the diagnosis is the fact that there are more than 50 different types of soft tissue sarcoma.

Treating Sarcoma

Treatment for sarcoma may vary depending on the type, stage and location of the tumor. At the Abramson Cancer Center, your multidisciplinary team will evaluate your specific needs and develop a custom treatment plan built with your cancer and lifestyle in mind. In general, sarcoma treatment almost always involves surgery and may involve chemotherapy and/or radiation therapy as well.

Dr. Weber's team at the Abramson Cancer Center is one of the top centers devoted to diagnosing and treating both soft tissue and bone sarcomas. It's comprised of nationally recognized experts with years of sarcoma experience, including medical, radiation, orthopaedic, and surgical oncologists; plastic surgeons; musculoskeletal radiologists; pathologists; physical therapists; nutritionists; and social workers.

The goal of sarcoma surgery and care, overall, is to remove the tumor while maintaining as much function and quality of life as possible. This is something that Dr. Weber's team keeps top of mind for every patient they treat.