Outcome predictors of clinically diagnosed benign upper extremity soft tissue masses: A retrospective study

Benign soft tissue tumors of the upper extremity are often overlooked in the existing literature despite their prevalence and risk of complications. The goals of this retrospective study are to identify predictors of complication and malignancy in upper extremity masses and to discuss management strategies for soft tissue swellings with predictors that worsen outcomes. Data from 70 patients who had surgically excised upper extremity tumors in two Malaysian tertiary hospitals from 2020 to 2021 were collected. Bone tumors, arthritic deformities, osteophytes, highly suspicious tumors suggestive of malignancy, and swelling on other parts of the body besides the upper limb were excluded from the study. Upper extremity tumor characteristics such as size, location, histological diagnosis, and related complications were recorded. Fisher's Exact Test was used to assess associations between outcomes and tumor characteristics. A p-value <0.05 was considered statistically significant. Nearly all upper extremity soft tissue masses were benign (97 %), with granulomas being the most common (20 %), followed by ganglion cysts (16 %), and giant cell tumors of the tendon sheath (14 %). A total of eight patients presented with complications, of which seven (88 %) had masses located on an exposed, high-contact surface. Size≥5 cm was a statistically significant predictor of complications but not malignancy. Additionally, histological diagnosis was significantly predictive of both complications and malignancy. Upper extremity soft tissue tumor size≥5 cm is predictive of complications such as rupture, recurrence, infection, impaired limb function, and misdiagnosis affecting treatment. Given the increased risk for complications, suspected benign tumors≥5 cm in greatest dimension are best managed with diagnostic and therapeutic surgical excision. • Granuloma, ganglion cyst, and giant cell tumor of the tendon sheath most common. • Any dimension≥5 cm significantly predictive of complications but not malignancy. • Histological diagnosis significantly predictive of complications and malignancy. • Manage masses≥5 cm with complete surgical excision even if suspected to be benign.