Ultrasound evaluation of superficial soft-tissue masses in paediatric patients – are we able to distinguish malignant tumours from benign masses?

Aims: The ultrasound seems to be the most suitable method for evaluation in children with soft tissue masses. It provides information about presence, size, location, structure and the margins of the lesion. The aim of this study was to prove the usefulness of US in distinguishing different malignant tumors from benign masses in soft tissues.

Methods: The retrospective studies involved 35 children, selected from the paediatric oncology outpatient department in 2000–2007.

Evaluations of the lesions were performed with GE LOGIQ 500 equipment with linear transducer 8.2–11.0MHz. In all cases, final diagnosis was established after histopathological evaluation of the materials from the open biopsy, or gained during surgical procedure. All the US examinations were recorded on S-VHS video.

Results: We present ultrasound images of 15 children with different benign masses in soft tissues such as lipomas, fibromas, angiomas, hemangioendothelioma and cysts etc. and 20 cases with malignant masses in soft tissues such as rhabdomyosarcomas, schwannomas, Ewing's sarcomas, neurofibroma, dermatofibrosarcoma, fibrosarcoma etc. We present ultrasound characteristic features of both benign and malignant masses. We encountered 4 false positive ultrasound results in all evaluated benign lesions. In case of malignant changes there were no false negative results.

Conclusions: However, literature questions ultrasound specificity to distinguish malignant tumours from benign masses, in our experience we gained a satisfactory level of ultrasound knowledge of soft tissues masses images, which is essential for appropriate differential diagnosis.

Relatively many false positive results, in our opinion were related with strong oncological awareness of the examiner.