Answer:
Approximately 30 percent of soft tissue fibrosarcomas occur in the
upper extremity, although hand involvement is extremely rare. They are
asssociated with radiation exposure 5-15 years prior to occurrence. Most
frequently, patients note a painless mass that may have been present for
a long time with recent growth. Plain x-rays may demonstrate soft tissue
calcification, fat density or unexpected bone involvement. MRI has become
increasingly valuable in determining the local extent of disease. Histologically
these tumors are compose of relatively uniform spindle-shaped cells resembling
fibroblasts arranged in long fascicles. Following wide excision of a lesion,
patients require either brachytherapy or external beam radiation. Patients
with a large high-grade lesion or with metastasis may benefit from chemotherapy.