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Soft tissue sarcomas are uncommon, with 4% of cases occurring in the hand.1 Despite being one of the more common soft tissue sarcomas in adults, liposarcoma is uncommonly described in the hand. We describe a case of a pleomorphic liposarcoma (PLS) of the left hand, which is a rare entity occurring in a rare location.
A middle-aged patient presented with a 2-year history of a large lump at the left hand first web space, which was noted to be recently increasing in size. No redness, pain or preceding history of trauma was noted. Hand examination revealed a non-tender, soft to firm multilobulated lump at the left hand first web space, which was not attached to skin.
Plain radiography of the patient's left hand showed a well circumscribed soft tissue swelling with mild impression on the adjacent surface of the first metacarpal bone but no associated calcifications or bony fracture (figure 1).
The patient underwent exploration and excision biopsy of the lump. Intraoperatively a 4×5×6 cm multilobulated lump was noted in the left hand first web space (figure 2), extending in between the two layers of muscles in the web space with multiple small feeder vessels seen. The lump …