Soft-Tissue Masses

Understanding Soft Tissue Masses
When patients come to see me about a soft tissue mass, they often describe it as a “lump” under the skin. These masses can vary greatly in size, location, and cause. The most common benign masses I encounter include lipomas, which are fatty growths, and epidermal inclusion cysts, which form under the skin when oil glands become blocked. While most soft tissue masses are not cancerous, it’s important to remember that some can represent more serious conditions, such as sarcomas or other rare malignancies.

Why Pathology Matters
Even when a mass looks like a simple lipoma or cyst, I always emphasize the importance of sending the tissue for pathological analysis after removal. Pathology allows us to confirm the diagnosis and rule out malignancy. On rare occasions, something that appears benign can turn out to be cancerous, and early detection makes all the difference in treatment and long-term outcomes. This step provides peace of mind for both me and the patient, ensuring that nothing is overlooked.

Techniques for Removal
The technique I use to remove a soft tissue mass depends on its size, depth, and location. Small, superficial lipomas or cysts can often be removed through a small incision directly over the mass, while larger or deeper ones may require a more extensive dissection. My goal is always to remove the mass completely, including any capsule, to minimize recurrence. I use careful dissection to preserve surrounding tissues and achieve the best cosmetic and functional results possible.

In-Office Versus Operating Room
A common question is whether removal can be done in the office or if it needs to be scheduled in the operating room. Smaller, superficial masses are usually safely removed in the office under local anesthesia, often in less than an hour. Larger, deeper, or more complex masses—particularly those near major blood vessels, nerves, or located in the abdominal wall or extremities—are better treated in the operating room. There, I have access to full anesthesia support, advanced equipment, and better visualization for more complicated dissections.

Factors in Decision-Making and Outcomes
The decision about where and how to remove a mass depends on multiple factors: the size and depth of the lesion, its proximity to critical structures, the patient’s comfort, and any underlying medical conditions. Regardless of the setting, the outcomes are usually excellent, with patients experiencing quick recovery and minimal scarring. By combining careful surgical technique with pathology confirmation, we not only resolve the discomfort or cosmetic concern of a soft tissue mass but also ensure patient safety through accurate diagnosis.