Tumor List

Synovial chondromatosis presents as the gradual onset of monoarticular pain and stiffness. If allowed to continue, the slow, progressive symptoms can result in decreased range of motion, effusions, crepitation and eventual locking of the joint. This condition has also been described in the synovium, soft tissue and bursae. Secondary synovial chondromatosis may be present after long standing osteoarthritis.
There are several possible etiologies for synovial chondromatosis. Trauma is supported by the fact that the process occurs primarily in weight bearing and dominant upper extremity joints. Infection is another possible culprit. Another theory postulates that cartilage shed into the joint is taken up by the synovium.

The presentation of chondrosarcoma depends on the grade of the tumor. A high-grade, fast growing tumor can present with excruciating pain. A low grade, more indolent tumor is more likely to present as an older patient complaining of hip pain and swelling. Pelvic tumors present with urinary frequency or obstruction or may masquerade as "groin muscle pulls".

The lesion presents as a slow growing mass with mild pain.

Approximately 80% of these tumors occur in the extremities, and 20% in the trunk. The lower extremity is the most common site. Patients present with swelling, and the tumor can be quite bulky.

The clinical presentation depends on the location of the tumor. Sacrococcygeal tumors often present as low back pain with no characteristic pattern or time course. Sacrococcygeal tumors can also present as bowel and bladder dysfunction. Presacral tumors can often be palpated on rectal exam, but this simple examination technique is often overlooked. Sacral tumors are often large at presentation as a large volume of tumor can be accommodated within the pelvis. Anterior cervical tumors can present as dysphagia and posterior cervical tumors can cause neurological deficits. Tumors at the base of the skull may present with headaches.

Patients typically present with pain and a mass. Approximately 90% of patients present with pain. The aggressive nature of the sarcoma is typically reflected by rapid growth, a pathological fracture, or severe and increasing pain. Approximately 12% of patients have pathologic fracture.

Patients present with an enlarging mass. It may be soft and fleshy and relatively painless. Some cases can become very large and remain painless.

Clinical findings include pain late in the clinical course and swelling. It may present as an effusion if near a joint. Only 12% present with a pathological fracture.

Monostotic fibrous dysplasia may be completely asymptomatic and is often an incidental finding on x-ray. Pain and swelling at the site of the lesion can also be present. Female patients may have increased symptoms during pregnancy. Unfortunately, this tumor can also present as a pathological fracture that is followed by a nonunion or malunion.

The tumor presents clinically as a painless, enlarging mass.

Patients present with pain and a slow growing mass.

Localized and disseminated GA are the two most common types.

Localized GA comprises about 3 out of 4 cases. One or several small, firm, flesh colored or eyrhematous papules are seen, which may form a ring, and slowly expand in diameter. These lesions typically occur on the lateral and dorsal surfaces of the hands and feet.

Disseminated or generalized GA is characterized by widespread lesions similar in nature to those in localized GA. The lesions may last for several years. Lesions may improve in winter and worsen in summer.

Subcutaneous GA is most common in children 2 to 5 years old. This form most often manifests as a large, asymptomatic soft tissue mass. Although nodules are usually stable for months, they may rapidly enlarge over the course of weeks. Patients with subcutaneous GA present with a firm, nontender, flesh-colored or pinkish nodule without overlying epidermal alteration .Lesions are typically solitary but may occur in clusters. The most commonly reported site of involvement is the lower extremities (65% of cases), often on the pretibial surface. Other typical sites include the fingers and palms and the dorsa of the feet. The buttocks, forehead, and scalp are less commonly affected. Deep dermal or subcutaneous nodules on the extremities are attached to fascia and are often therefore mobile, whereas lesions on the scalp are attached to underlying periosteum and are therefore fixed or only slightly mobile. These lesions do not progress to a systemic illness.

Perforating is a rare type, more common in women, and found on the upper limbs and pelvis, abdomen, trunk, and extremities. The lesions may cause itching and pain.

Patients normally have pain accompanied by significant diffuse swelling. The area may appear inflamed and a misdiagnosis of infection can be made. The white blood cell count, erythrocyte sedimentation rate and temperature may all be moderately elevated.

Patients have symptoms for an average of 14 months prior to diagnosis. Patients with hindfoot lesions have an average duration of symptoms of 22 months prior to diagnosis, whereas those with forefoot lesions have an average duration of symptoms of seven months.

The tumor may present as a small, firm superficial or deep nodule or a focal cluster of nodules. Regional multifocal presentation is an unusual characteristic displayed by this tumor. This tumor is frequently misdiagnosed as a skin condition, warts, or corns, and a correct diagnosis may be delayed with serious medical and legal consequences. About one half of the tumors are not painful. The tumor occurs in both subcutis and deeper tissues. When located in the subcutis, it usually presents as a firm nodule that may be solitary or multiple, has a calluslike consistency, and is often described as a “woody hard knot” or :firm lump” that is slow growing and painless. Nodules situated in the dermis are often elevated above the skin surface and frequently become ulcerated weeks or months after they are first noted. Such lesions are often erroneously diagnosed as an “indurated ulcer”, “draining abscess”, or “infected wart” that fails to heal despite intensive therapy. The majority of tumors are 3 to 6 cm in diameter.

The presentation of synovial sarcoma is variable and may mimic a benign process such as ganglion cyst. The patient may have a mass that has been present for months, years, or even decades, with slow growth and little or no symptoms. There may have been recent rapid growth of a lesion that has been present for years without apparent change. Conversely, some of these sarcomas may be very painful from the outset. The average duration of symptoms before diagnosis is 21 months.