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Lipoma — SCE Dermatology MCQ

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HardDermatological SurgeryLipomaSCE Dermatology

A 46-year-old woman reports an unexplained deep thigh lump that has enlarged from 3 cm to 6 cm over eight weeks. It is painless and the overlying skin is normal. What is the next investigation in the NICE suspected-cancer pathway?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Arrange urgent direct-access ultrasound, to be performed within two weeks

Explanation lettering: B = shown as A · D = shown as B · A = shown as C · C = shown as D

C is correct. NICE advises urgent direct-access ultrasound within two weeks for an adult with an unexplained soft-tissue lump that is increasing in size. If ultrasound suggests a soft-tissue sarcoma, or is uncertain and concern persists, the patient enters the suspected-cancer referral pathway. Painlessness and normal surface skin do not make an enlarging deep mass benign. Delayed radiographic review risks diagnostic delay, unplanned primary-care excision can compromise definitive surgery, and fine-needle aspiration is not the pathway’s initial investigation. The item tests recognition of a growth red flag rather than the elementary histological definition of a lipoma.

Reference: NICE NG12 suspected-cancer recognition and referral: https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer