Soft tissue solitary fibrous tumors of the musculoskeletal system: spectrum of MRI appearances and characteristic imaging features

AbstractTumors around the elbow are infrequent, and delayed diagnosis is a common theme because of the low incidence and lack of familiarity. However, just like any other site, the radiologic work-up of musculoskeletal tumors around the elbow remains the same, with plain films the first investigation in a patient with a suspected bone tumor and ultrasound the first modality to evaluate a soft tissue lump. The management of both bone and soft tissue tumors around the elbow is unique because of a large number of important structures in an anatomically confined space and little normal tissue to spare without severely compromising the joint's function. Many benign nonneoplastic entities can mimic bone and soft tissue tumors on imaging. It is important to keep the characteristic imaging appearance in mind while formulating a differential diagnosis to avoid an unnecessary additional work-up. This article reviews the most common benign and malignant bone and soft tissue tumors around the elbow, mimickers, imaging features, and current therapeutic concepts.

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Imaging and Pathological Features of Alveolar Soft Part Sarcoma: Analysis of 16 Patients

Indian Journal of Radiology and Imaging ◽

10.1055/s-0041-1735501 ◽

2021 ◽

Author(s):

Malvika Gulati ◽

Abhenil Mittal ◽

Adarsh Barwad ◽

Rambha Pandey ◽

Sameer Rastogi ◽

...

Keyword(s):

Young Adults ◽

Soft Tissue ◽

Soft Part ◽

Alveolar Soft Part Sarcoma ◽

Preoperative Imaging ◽

Histopathological Diagnosis ◽

Imaging Features ◽

Common Site ◽

Hyperintense Signal ◽

Characteristic Imaging

Abstract Context Alveolar soft part sarcoma (ASPS) is a rare soft tissue tumor most commonly occurring in deep intramuscular plane of lower extremities of adolescents and young adults. It is a highly vascular, slow growing tumor with malignant potential having lung as the most common site of metastases at the time of presentation. Aims The aim is to review the imaging findings of ASPS and determine characteristic imaging features of this rare tumor. Materials and Methods Sixteen patients having histopathological diagnosis and preoperative imaging of ASPS attending the dedicated sarcoma clinic at our institute were included in the study. The demographic, clinical, and imaging data were retrieved from the case records and then evaluated for characteristic imaging features which may raise suspicion of ASPS. Results The patients ranged from 3 to 72 years of age and with a slight male preponderance. Of the eight CECTs evaluated, 62.5% tumors showed well-defined lobulated margins, 87.5% cases showed intense enhancement with presence of feeder vessels. On CEMRI of 10 patients, 70% had well circumscribed lobulated margins with intense enhancement and tortuous flow voids in most of them. All cases showed T2 hyperintense signal. Fourteen of 16 (87.5%) patients had metastatic disease with lung as the most common site (92.8%). Conclusion ASPS is a rare soft tissue sarcoma seen in children and young adults. Imaging may mimic a vascular malformation due to the presence of tortuous feeders. Misdiagnosis at an early stage may lead to later metastatic presentation of the disease, thus emphasizing the need to suspect it on imaging.

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Myxofibrosarcoma: clinical and prognostic value of MRI features

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616999200729152135 ◽

2020 ◽

Vol 16 ◽

Cited By ~ 1

Author(s):

Paolo Spinnato ◽

Andrea Sambri ◽

Tomohiro Fujiwara ◽

Luca Ceccarelli ◽

Roberta Clinca ◽

...

Keyword(s):

Soft Tissue ◽

Local Recurrence ◽

Contrast Enhancement ◽

Imaging Modality ◽

Soft Tissue Sarcomas ◽

The Elderly ◽

High Rate ◽

Imaging Features ◽

High Grade ◽

Mri Features

: Myxofibrosarcoma is one of the most common soft tissue sarcomas in the elderly. It is characterized by an extremely high rate of local recurrence, higher than other soft tissue tumors, and a relatively low risk of distant metastases.Magnetic resonance imaging (MRI) is the imaging modality of choice for the assessment of myxofibrosarcoma and plays a key role in the preoperative setting of these patients.MRI features associated with high risk of local recurrence are: high myxoid matrix content (water-like appearance of the lesions), high grade of contrast enhancement, presence of an infiltrative pattern (“tail sign”). On the other hand, MRI features associated with worse sarcoma specific survival are: large size of the lesion, deep location, high grade of contrast enhancement. Recognizing the above-mentioned imaging features of myxofibrosarcoma may be helpful to stratify the risk for local recurrence and disease-specific survival. Moreover, the surgical planning should be adjusted according to the MRI features

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Imaging Features of Primary Tumors of the Hand

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405616999200817173154 ◽

2020 ◽

Vol 16 ◽

Author(s):

Filippo Boriani ◽

Edoardo Raposio ◽

Costantino Errani

Keyword(s):

Soft Tissue ◽

Soft Tissues ◽

Epithelioid Sarcoma ◽

Case Series ◽

Malignant Neoplasm ◽

Benign Tumors ◽

Imaging Features ◽

Primary Tumors ◽

Therapeutic Decisions ◽

Tumors Of The Hand

: Musculoskeletal tumors of the hand are a rare entity and are divided into skeletal and soft tissue tumors. Either category comprises benign and malignant or even intermediate tumors. Basic radiology allows an optimal resolution of bone and related soft tissue areas, ultrasound and more sophisticated radiologic tools such as scintigraphy, CT and MRI allow a more accurate evaluation of tumor extent. Enchondroma is the most common benign tumor affecting bone, whereas chondrosarcoma is the most commonly represented malignant neoplasm localized to hand bones. In the soft tissues ganglions are the most common benign tumors and epithelioid sarcoma is the most frequently represented malignant tumor targeting hand soft tissues. The knowledge regarding diagnostic and therapeutic management of these tumors is often deriving from small case series, retrospective studies or even case reports. Evidences from prospective studies or controlled trials are limited and for this lack of clear and supported evidences data from the medical literature on the topic are controversial, in terms of demographics, clinical presentation, diagnosis prognosis and therapy.The correct recognition of the specific subtype and extension of the tumor through first line and second line radiology is essential for the surgeon, in order to effectively direct the therapeutic decisions.

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Head and neck osteosarcoma: CT and MR imaging features

Dentomaxillofacial Radiology ◽

10.1259/dmfr.20190202 ◽

2020 ◽

Vol 49 (2) ◽

pp. 20190202

Author(s):

Zhendong Luo ◽

Weiguo Chen ◽

Xinping Shen ◽

Genggeng Qin ◽

Jianxiang Yuan ◽

...

Keyword(s):

Soft Tissue ◽

Head And Neck ◽

Giant Cell ◽

High Signal ◽

Imaging Features ◽

Matrix Mineralization ◽

Imaging Characteristics ◽

Mri Features ◽

Signal Intensities ◽

Ct And Mri

Objective: This study aims to assess the CT and MRI features of head and neck osteosarcoma (HNO). Methods: 37 HNOs were identiﬁed, and the following imaging characteristics were reviewed on CT and MRI. Results: A total of 37 patients(age 41.5 ± 15.0 years old; 16 males, 21 females) were included in the study. Tumours occurred in the maxilla (16, 43.2%), mandible (8, 21.6%), skull base (6, 16.2%), calvarium (5, 13.5%), paranasal sinuses (1, 2.7%) and cervical soft tissue (1, 2.7%). 16 patients received radiotherapy for nasopharyngeal carcinoma. Three patients (8.1%) developed osteosarcomas related to a primary bone disease. 16 of the (43.2%) tumours demonstrated lytic density on CT scans, followed by 13 (35.1%) showing mixed density and 7 (18.9%) with sclerotic density. Matrix mineralization was present in 32 (86.5%). 3 out of 24 (12.5%) tumours showed lamellar periosteal reactions, 21 out of 24 (87.5%) showed spiculated periosteal reactions. 12 tumours showed low signal intensities on T1WI, with 16 having heterogeneous signal intensities. 10 tumours showed high signal intensities on T2WI, and 18 showed heterogeneous signal intensities. With contrast-enhanced images, 3 tumours showed homogeneous enhancement (2 osteoblastic and 1 giant cell-rich), 18 tumours showed heterogeneous enhancement (13 osteoblastic, 4 fibroblastic and 1 giant cell-rich), and 7 tumours showed peripheral enhancement (6 chondroblastic and 1 osteoblastic). These tumours were characterized by soft tissue masses with a diameter of 5.6 ± 1.8 cm. Conclusions: HNO is a rare condition and is commonly associated with previous radiation exposure. This study provides age, sex distribution, location, CT and MRI features of HNO.

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Promoting musculoskeletal system soft tissue regeneration by biomaterial-mediated modulation of macrophage polarization

Bioactive Materials ◽

10.1016/j.bioactmat.2021.04.017 ◽

2021 ◽

Vol 6 (11) ◽

pp. 4096-4109

Author(s):

Jinchun Ye ◽

Chang Xie ◽

Canlong Wang ◽

Jiayun Huang ◽

Zi Yin ◽

...

Keyword(s):

Soft Tissue ◽

Tissue Regeneration ◽

Musculoskeletal System ◽

Macrophage Polarization ◽

Soft Tissue Regeneration

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Imaging diagnosis of classical and new pneumoconiosis: predominant reticular HRCT pattern

Insights into Imaging ◽

10.1186/s13244-021-00966-y ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Akira Masanori

Keyword(s):

Computed Tomography ◽

Interstitial Lung Disease ◽

Imaging Features ◽

Imaging Findings ◽

Imaging Diagnosis ◽

High Resolution Computed Tomography ◽

Pleural Fibrosis ◽

Pathologic Findings ◽

Characteristic Imaging ◽

The Individual

AbstractOur understanding of the manifestations of pneumoconioses is evolving in recent years. Associations between novel exposures and diffuse interstitial lung disease have been newly recognized. In advanced asbestosis, two types of fibrosis are seen, probably related to dose of exposure, existence of pleural fibrosis, and the host factor status of the individual. In pneumoconiosis of predominant reticular type, nodular opacities are often seen in the early phase. The nodular pattern is centrilobular, although some in metal lung show perilymphatic distribution, mimicking sarcoidosis. High-resolution computed tomography enables a more comprehensive correlation between the pathologic findings and clinically relevant imaging findings. The clinician must understand the spectrum of characteristic imaging features related to both known dust exposures and to historically recent new dust exposures.

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Prognostic Assessment in High-Grade Soft-Tissue Sarcoma Patients: A Comparison of Semantic Image Analysis and Radiomics

Cancers ◽

10.3390/cancers13081929 ◽

2021 ◽

Vol 13 (8) ◽

pp. 1929

Author(s):

Jan C. Peeken ◽

Jan Neumann ◽

Rebecca Asadpour ◽

Yannik Leonhardt ◽

Joao R. Moreira ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcomas ◽

Treatment Decision ◽

Staging System ◽

Predictive Performance ◽

Machine Learning Techniques ◽

Clinical Staging ◽

Imaging Features ◽

Prognostic Assessment ◽

Selection Operator

Background: In patients with soft-tissue sarcomas of the extremities, the treatment decision is currently regularly based on tumor grading and size. The imaging-based analysis may pose an alternative way to stratify patients’ risk. In this work, we compared the value of MRI-based radiomics with expert-derived semantic imaging features for the prediction of overall survival (OS). Methods: Fat-saturated T2-weighted sequences (T2FS) and contrast-enhanced T1-weighted fat-saturated (T1FSGd) sequences were collected from two independent retrospective cohorts (training: 108 patients; testing: 71 patients). After preprocessing, 105 radiomic features were extracted. Semantic imaging features were determined by three independent radiologists. Three machine learning techniques (elastic net regression (ENR), least absolute shrinkage and selection operator, and random survival forest) were compared to predict OS. Results: ENR models achieved the best predictive performance. Histologies and clinical staging differed significantly between both cohorts. The semantic prognostic model achieved a predictive performance with a C-index of 0.58 within the test set. This was worse compared to a clinical staging system (C-index: 0.61) and the radiomic models (C-indices: T1FSGd: 0.64, T2FS: 0.63). Both radiomic models achieved significant patient stratification. Conclusions: T2FS and T1FSGd-based radiomic models outperformed semantic imaging features for prognostic assessment.

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Imaging features of hemangioma in long tubular bones

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03882-2 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Lei Cao ◽

Jin-Xu Wen ◽

Shu-Man Han ◽

Hui-Zhao Wu ◽

Zhi-Gang Peng ◽

...

Keyword(s):

Soft Tissue ◽

Plain Radiograph ◽

Ground Glass Opacity ◽

Plain Radiography ◽

Long Bone ◽

Imaging Features ◽

Mri Imaging ◽

Soft Tissue Density ◽

Tissue Density ◽

Hyperintense Signal

Abstract Background To investigate the imaging features of hemangiomas in long tabular bones for better diagnosis. Methods Twenty-four patients with long bone hemangiomas confirmed by pathology were enrolled. Nineteen patients had plain radiography, fourteen patients had computed tomography (CT) and eleven had magnetic resonance imaging (MRI). The hemangioma was divided into medullary [13], periosteal [6] and intracortical type [5]. Results Among 19 patients with plain radiography, eleven patients were medullary, three periosteal, and five intracortical. In the medullary type, the lesion was primarily osteolytic, including five cases with irregular and unclear rims and one lesion having osteosclerotic and unclear rims. In three patients with the periosteal type, the lesion had clear rims with involvement of the cortical bone in the form of bone defect, including two cases with local thickened bone periosteum and one case having expansile periosteum. Five intracortical hemangiomas had intracortical osteolytic lesions with clear margins. Among 14 patients with CT imaging, 8 cases were medullary, three periosteal, and three intracortical. Among 8 medullary hemangiomas, one had ground glass opacity, and seven had osteolytic, expansile lesions like soft tissue density with no calcification. In three periosteal cases, the lesion was osteolytic with thickened periosteum and narrowed medullary cavity. In three intracortical hemangiomas, the lesion was of even soft tissue density with no calcification. Among 11 patients with MRI imaging, seven were medullary, two periosteal, and two intracortical. Among 7 medullary lesions, six were of hypointense signal on T1WI and hyperintensesignal on T2 WI. In two periosteal cases, the periosteum was thickened, with one case being of equal signal, and the other having no signal. Two intracortical hemangiomas were both of slightly low signal on T1WI but hyperintense signal on T2WI. Conclusions The long bone hemangiomas had characteristic cystic honeycomb-like presentations in plain radiograph. CT and MRI imagings are helpful for diagnosis of hemangiomas in long bone.

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