If you have a known bone or soft-tissue lesion but do not yet know the cause, your doctor may order tests to gather more information. Common tests include state-of-the-art imaging, physical exam and biopsy. Once your tests are complete, your doctor will discuss the results, confirm your diagnosis and help you decide on your next steps.
Diagnosing your tumor
Before we can treat your bone or soft-tissue tumor, we need to identify what it is and, if possible, why it occurred. This process may involve several steps. You may have one or more of these tests to help your doctor confirm a diagnosis:
- Medical history: We will review your medical history to look for clues that might show what type of lesion or tumor you have and what caused it.
- Physical exam: Physical examination can sometimes provide additional information about the origin of your tumor or lesion.
- Imaging studies: For many bone or soft-tissue tumors, radiological imaging studies are the most valuable initial tool that we have. We will review any prior X-rays, CT (CaT) scans, MRIs, or other scans you have received. You may be asked to undergo more imaging. Some tumors can be identified successfully based on their imaging characteristics, and others cannot.
- Lab studies: Sometimes sending a blood sample to the Dartmouth Hitchcock Medical Center lab for analysis is useful in determining a diagnosis.
- Biopsy: For tumors that are not identified with imaging or lab studies, a biopsy may be required. Biopsies can be performed in our clinic, by a radiologist using an ultrasound or CT machine to visualize the tumor, or sometimes in the operating room. Many factors dictate the type of biopsy you will receive, but some of the most common factors include the tumor’s location and potential diagnosis.
Treating your tumor
Your treatment will vary based on your diagnosis and preferences.
Many lesions are treated by continued observation, physical exam, and imaging studies. Some benign tumors need surgery and/or the use of additional treatment such as chemotherapy and radiation, but this is rare.
Malignant tumors generally need some combination of surgery, chemotherapy, and radiation.
- Surgery is the physical removal of the tumor. Malignant tumors are removed along with a region of healthy tissue around the tumor to ensure that no tumor is left behind. The Center for Surgical Innovation is the only surgical center in the world that permits image-guided surgery. Patients requiring complex surgeries that would benefit from MRI and CT guidance can have their surgery performed in the Center for Surgical Innovation.
- Chemotherapy is the infusion of medications that are toxic to the tumor.
- Radiation therapy is the application of ionizing radiation to the tumor to cause damage to the tumor’s DNA and prevent the tumor cells from dividing.
If you have lesions that appear benign, you may have follow-up appointments for additional examinations and imaging.
If you need surgery or other treatment for a benign condition, we will create a treatment plan defined by your diagnosis.
If you have a malignant tumor, particularly a sarcoma, you will be followed by your treatment team for many years. Your diagnosis determines the frequency of follow-up.