Lab Studies:
Lab workup was significant for elevated potassium of 5.3, and elevated total bilirubin of 1.7. CBC was within normal limits.
Other Studies:
A lateral radiograph of the right knee was done and revealed a posterior soft tissue mass <a href="CaseStudyImages/CS2CS1IsitaCystorisi-1193.jpg" title="Case Photo #2" data-lity><b>Case Photo #2</b></a> . An anterior-posterior view of the bilateral knees was done and did not appreciate any joint space narrowing. Subsequently, a magnetic resonance imaging (MRI) of the right knee was done and revealed a 5.1 x 4.3 x 3.0 cm peripherally enhancing mass involving the posterior right knee subcutaneous soft tissues that was considered to be a primary soft tissue sarcoma (STS) <a href="CaseStudyImages/CS3CS2CS1IsitaCystor-1193.jpg" title="Case Photo #3" data-lity><b>Case Photo #3</b></a> . A biopsy of the right popliteal protrusion was done and the pathology was positive for a stage 1 grade IB fibrosarcoma
Consultations:
Orthopedics/Sports Medicine was initially consulted for evaluation of a popliteal cyst that was concerning on physical exam. Ortho-oncology was then consulted for concern of a soft tissue sarcoma.
Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.