Even if it's the same diagnosis, we don't necessarily use the same approach if the tumors are in different locations. Even the patient's occupation is taken into consideration. For example, a pianist was recently diagnosed with a chest sarcoma near the top of his arm. In the initial evaluation of bone or soft tissue tumors, plain radiographs help determine how aggressive the lesion is and which further studies may be necessary. For large benign-appearing tumors, those of indeterminate status, or aggressive malignancies, MRI and CT scans may be the next step to determine the full extent of the lesion and its relationship to surrounding structures.
Bone scans help determine multiple bone involvement.
Surgical Reconstruction Most of Wirganowicz's cases involve unidentified masses in soft tissues or bone, often uncovered by x-rays. Although the origin of most tumors of the extremities can be uncertain, it is rarely trauma. An injury, Wirganowicz stressed, merely draws attention to the tumor. An unusual pain or mass may be treated as a muscle pull or sports injury, mistakenly attributed to a traumatic event. Patients will say to a family practitioner, 'I've had a bump on my leg for six months.