By – Dr. Mayur Kamani- ORTHOPAEDIC ONCO-SURGERY, HCG Aastha Cancer Centre – Ahmedabad
Muscle aches, joint stiffness, and swelling are common complaints among active individuals. Most of the time, these symptoms result from overuse or minor strain and tend to improve with rest, ice, or physical therapy. However, on rare occasions, what appears to be a lingering sports injury could be the first sign of a soft tissue sarcoma.
Soft tissue sarcomas are rare cancers that form in the body’s connective tissues—such as muscles, fat, nerves, blood vessels, or tendons. Although they make up less than 1% of adult cancers, they often mimic benign or injury-related conditions. This similarity can lead to delays in diagnosis, allowing the disease to progress unnoticed.
When to Look Closer
Sarcomas often present differently from typical injuries. While sprains or strains usually follow a specific incident and improve within weeks, sarcomas do not. They may begin as a painless lump deep within a limb, often mistaken for a muscle knot, bruise, or hematoma. When pain does occur, it is typically persistent rather than sharp or related to movement.
A key warning sign is a lump that slowly increases in size—especially if it grows larger than 5 cm, feels firm beneath the skin, or does not resolve over time. If discomfort or swelling continues despite rest, medication, or physiotherapy, a more thorough medical evaluation should be considered. In some cases, such lumps remain unnoticed or ignored for months under the assumption that they will eventually heal.
Why Early Diagnosis Matters
Treatment outcomes for sarcoma depend greatly on early detection. When diagnosed at an early, localized stage, surgery—sometimes combined with radiation—can be highly effective. However, if the cancer spreads to the lungs or other organs, treatment becomes more difficult and survival rates decrease significantly.
Because of their rarity and similarity to benign conditions, sarcomas are often misdiagnosed or overlooked. Primary care physicians, physiotherapists, and even orthopedic specialists may not suspect malignancy unless the mass behaves unusually. To prevent delays, general guidance is straightforward: any unexplained lump that does not reduce in size within two weeks should be evaluated further.
Imaging and Diagnosis
If a sarcoma is suspected, imaging studies such as ultrasound or MRI are typically the first steps. These help assess the mass in terms of size, depth, blood supply, and relation to nearby structures. If imaging raises concern, a core needle biopsy—performed by an oncology team—is essential. This provides tissue for analysis and helps determine the exact type of tumour.
It is critical that any biopsy be performed under the supervision of a specialist. A poorly placed biopsy can complicate future surgery and increase the risk of recurrence.
Not All Lumps Are Cancerous—But Caution Matters
Most soft tissue lumps are benign—such as lipomas, cysts, or fibrous nodules. Even during a physical exam, it can be difficult to differentiate a harmless lump from something more serious. Some low-grade sarcomas may even appear non-threatening on imaging. That’s why sound clinical judgment—and referring patients at the appropriate time—can make a critical difference.
Certain individuals face a higher risk, such as those with Li-Fraumeni syndrome, a family history of sarcoma, or prior radiation exposure. In such cases, any unusual swelling should be evaluated without delay.
When to Seek Medical Help
· Referral to a sarcoma specialist is strongly advised if a lump:
· Measures over 5 cm
· Lies deep beneath the muscle fascia
· Continues to grow
· Causes unexplained pain or loss of function
· Recurs after prior removal
Early evaluation by a multidisciplinary sarcoma team ensures accurate diagnosis and offers the broadest range of treatment options—especially when complete surgical removal is possible.
Though soft tissue sarcomas are uncommon, missing the diagnosis can have serious consequences. Recognizing when a symptom deserves further evaluation is vital. For both doctors and patients, knowing when to look beyond a presumed injury can make all the difference. Early imaging, timely biopsy, and expert referral remain key to improving survival and preserving function.