E1383. Not Your Everyday Lumps and Bumps: A Case-Based Review of Uncommon Superficial Soft Tissues Masses on Ultrasound
  1. David Kakish; University of California, Irvine
  2. Saba Naamo; Geisinger
  3. Peter Wang; University of California, Irvine
  4. Thomas Duong; University of California, Irvine
  5. Mohammad Helmy; University of California, Irvine
  6. Roozbeh Houshyar; University of California, Irvine
  7. James Shi; University of California, Irvine
General practitioners are increasingly utilizing point-of-care ultrasound. In fact, ultrasound is quickly gaining popularity with trainees in a multitude of specialties as a majority and growing number of medical schools and residency programs integrate ultrasound education into their curricula. Studies have shown that generalists can adequately rely on point-of-care ultrasound–given sufficient pretest probability–to support their diagnoses in a broad range of clinical settings. While the overwhelming majority of superficial soft tissue masses are benign, imaging remains crucial to confirm a clinician’s suspicion and target lesions for biopsy. With the appropriate experience, ultrasound demonstrates a high diagnostic accuracy for superficial soft tissue masses; however, it is vital for interpreting physicians to be comfortable with not only frequently encountered masses, but also uncommon lesions–both benign and malignant. This educational exhibit will review uncommon superficial soft tissue masses using a case-based format with an emphasis on their sonographic characteristics. The goal of this exhibit is to educate practicing radiologists, trainees, and clinicians on less frequently encountered superficial soft tissue lesions to increase diagnostic confidence and improve subsequent management.

Educational Goals / Teaching Points
The goal of this educational exhibit is to provide a case-based review of uncommon superficial soft tissue masses as characterized by ultrasound. Each case will provide a patient history, clinical photograph when available, sonographic imaging, correlate imaging in an additional modality when available, a description of the key ultrasound findings, the diagnosis, and a review of the diagnosis, including associated demographic information, pathophysiology, imaging findings, and management. Thus, viewers will develop an awareness of relevant demographic information and key imaging findings on ultrasound that aid in the diagnosis of these lesions. At the same time, it is vital for radiologists to be cognizant of malignant features as ultrasonography has inherent limitations. Potential pitfalls will also be discussed and emphasized as appropriate.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The key anatomic and pathophysiologic issues evaluated will be uncommon superficial soft tissue masses on the head, extremities, breasts, and trunk. Ultrasound will be the primary imaging technique discussed and the associated findings will be described. Ultrasonography is fast, targeted, inexpensive, and lacks ionizing radiation. For superficial or palpable soft tissue masses, ultrasound is “usually appropriate” as the initial imaging study and considered “equally appropriate” alongside radiographs as the initial imaging study according to the American College of Radiology (ACR) Appropriateness Criteria.

Ultrasound is the ideal initial diagnostic imaging modality for assessing superficial soft tissue masses. As a result, diagnostic radiologists must be familiar with not only common superficial masses, but also the uncommon lesions and their sonographic characteristics.