Palpable Mass in Upper Extremity - Adolescent Female

Case at a Glance

A 17-year-old female presents with a one-year history of a palpable mass in her upper extremity that changes consistency with muscle contraction, concerned about possible soft tissue sarcoma.

Patient's Story

The patient is a 17-year-old female, 5'5" tall, weighing 114 lbs, who discovered a mass in her upper extremity approximately one year ago. She reports no current medications and describes significant anxiety regarding the possibility of soft tissue sarcoma. The patient notes that the mass becomes softer and less palpable when muscles are relaxed, but becomes firmer and more prominent with muscle contraction. She has been living with this concern for the past year and has scheduled a medical evaluation.

Initial Assessment

Physical examination reveals a palpable mass in the upper extremity that demonstrates variable consistency depending on muscle tension. The mass appears to be deeper when muscles are relaxed and becomes more superficial and firm during muscle contraction. Patient appears anxious but otherwise well. Vital signs stable. No apparent lymphadenopathy or systemic symptoms reported.

The Diagnostic Journey

Given the patient's age, the duration of symptoms, and the characteristic behavior of the mass with muscle contraction/relaxation, differential diagnosis includes benign soft tissue lesions such as lipoma, muscle herniation, or fibrous tissue. The patient's concern about soft tissue sarcoma, while understandable, appears less likely given the benign characteristics observed. Clinical photography documented the appearance and behavior of the mass over time, showing consistency in presentation from initial discovery in November 2024.

Final Diagnosis

Pending definitive medical evaluation scheduled within 48 hours of initial presentation. Clinical findings suggest benign etiology, likely muscle herniation or benign soft tissue mass.

Treatment Plan

Patient scheduled for comprehensive medical evaluation including physical examination by qualified physician. Diagnostic imaging may be considered based on clinical assessment. Patient counseling regarding anxiety management and realistic expectations about differential diagnosis.

Outcome and Follow-up

Awaiting formal medical evaluation. Patient advised to continue monitoring and proceed with scheduled appointment. Reassurance provided regarding low likelihood of malignant process based on clinical characteristics observed.