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Case 39: Discomfort between the shoulder blades.

For ten years this 65 year old lady has noticed a lump just to the right of the midline in the interscapular area. The lump has not grown, is not particularly tender, but causes pain when lifting.

1. What is the likely diagnosis?

Intramuscular lipoma

2. Which two criteria would you consider most important when deciding to preoperatively core biopsy this lesion under suspicion of being a sarcoma?

1. Size - greater than 5cm's requires consideration of preoperative biopsy and careful review of the imaging.

2. Position - Deep to the deep fascia. This again raises the concern of sarcomatous origin.

Further Reading
Reference : lipoma Reference : Deep lipoma

Powerpoint Presentations
Investigation and Staging of Soft Tissue Sarcoma Treatment Options to Soft Tissue Sarcoma