Susan H.

I am a 45-year-old female who is married and employed at Wake Forest University Baptist Medical Center/North Carolina Baptist Hospital in Winston-Salem, NC. I am an electroencephalogram (EEG) technician and work in neurology. Around October of 2006, I noticed that I started getting some bursitis-type pain in my left shoulder. I really did not worry about this because with my job, I get pain in the shoulders quite a lot. Towards the end of October, I received my flu shot that was given at the hospital in the left arm. My left shoulder started aching a lot more after the flu shot, and I would put a heating pad on it with no relief. On November 13th, I was getting ready to take a nice hot bath after working a hard day. I looked in the mirror and noticed this big swelling in the left deltoid. I was considerably bigger than that of the right deltoid. When I went to work the next day, I went to Employee Health, because I assumed that this was all related to the flu shot, and I had just had a first-time reaction to it or maybe it was the way it was given. They started me on an antibiotic and told me to use a heating pad. I went back to them on November 16th, because I was not getting any improvement or relief. They then sent me to Infectious Diseases that same day because we were thinking it was fluid from the flu shot that needed to be drained. When the physician saw me in Infectious Diseases, he wanted to do an ultrasound because the area was so big, he just did not want to keep poking me with a needle to drain my arm.

I went to get the Ultrasound that day and it was read as showing “diffusely hyperechoic soft tissues of the left upper arm with loss of superficial tissue planes. Associated hypoechoic collections within superficial soft tissues demonstrate prominent vascularity with arterial waveforms and the diagnosis includes cellulitis, infection/inflammatory process or vascular abnormality such as pseudoaneurysm or AV fistula.” They suggested an MRI of this area. I shared this report with one of my friends who is a neurologist the next day and on 11/17/06, I had an MRI scan that morning.

Without knowing the results yet and still thinking I am going to get this arm drained, I had an appointment with an orthopedic surgeon the afternoon right after the MRI scan. He pulled up the MRI scan and to his surprise he said that it looked like I had a gigantic blood clot in my arm and wanted to get the results of the MRI scan that was done a few hours before. When we got the radiologist on the phone, the surgeon came back to the office and told me that I had a large tumor in my arm and the MRI was suggestive of a liposarcoma and it needed to come out, so he set me up with an appointment to see an orthopedist oncologist who specializes in tumors at the Cancer Center at Wake Forest. My appointment was on 11/21/06. I was so much in shock in the office that day after he told me that it was a tumor. My husband was away on a trip, and I was just flabbergasted. I called him as soon as I left the surgeon’s office, and he came home that evening and we worried the weekend together.

On Monday, 11/20/06, I went to my family doctor to talk with him about this possible diagnosis and to get some comfort from him, as I have been seeing him over 20 years, and he knows my body better than anybody. He is also a good Christian man, and I am also a Christian, so we sat down and chatted and hugged as I left. He told me that the surgeon who I was going to see tomorrow is very experienced in this field, has a reputation of being an excellent tumor surgeon, and I was in good hands. He said I was very lucky to work where I do, because a lot of family doctors do not see this and would just think it was a lipoma and would not have known where to send anyone to.

We went to the Cancer Center to see Dr. W and he felt that it was either a lipoma or a low-grade liposarcoma after looking at the MRI. We scheduled my surgery for tumor removal on December 1st; I would just stay overnight in the Day Hospital. Well, I felt relieved after I spoke with Dr. W. and his PA. December 1st came pretty fast, as this was my very first surgery ever.

Everything went well with the surgery, and I spent the night in Day Hospital and was released the next day with a sling that I would wear for the next 3 weeks until I saw him back for follow-up. I had an incision in my arm about 12″ long. Well, I went on for 3 weeks without knowing whether this mass was benign or malignant, but deep in my heart I felt that it had some malignancy in it because it was so big and had grown so fast. When I went for my 3 week follow-up, I did find that the pathology report revealed a “well-differentiated (lipoma-like) liposarcoma. This mass was 15.5 x 7.5 x 3.5 cm. This lesion was well-encapsulated and deep. It was in the left posterior deltoid muscle. There was also a secondary lipomatous mass in a separate area in the nearby muscle which was about 1.5 x 1 x 0.5 cm. This second one was found to be a lipoma (benign) tumor.

They felt all we needed to do was to obtain a baseline postoperative MRI scan in approximately 3 months and then we would use that in the future as follow-up scans to evaluate for recurrence. He said the likelihood of this metastasizing was so low that he did not recommend any additional therapy and said that the likelihood of this recurring with the negative margins was low and therefore he did not recommend any radiation therapy and just to follow this long-term.

I have developed more of a deeper relationship with God these days because I know there is a purpose for everything. I thank God that I did get the flu shot because I may have not even paid attention to this area when I did or I don’t know if the flu shot caused the lesion to get irritated and grow faster, but I do thank God that I found it when I did and that I went to the right people right away instead of waiting. I hope this will help someone out there who has been to see their family doctor and their family doctor tells them that it is just a lipoma and not to worry about it. You do not know if it is a lipoma or liposarcoma until it is biopsied. Just remember this – I would rather go to an oncology surgeon who specializes in tumors right away before I would delay this anymore if you find a lump on you. Definitely get an MRI and have it biopsied. I too had never heard of liposarcoma and people ask me what this is all the time. I do know that it is very rare and that only 2% of the population get it. Not really great to be in that percentage is it?

I hope the best for all of you guys diagnosed with liposarcoma and I will definitely keep you in my prayers. Hope this helps someone.

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