Non-neoplastic Soft Tissue Tumors and Tumor-like Lesions

2020 ◽  
Vol 24 (06) ◽  
pp. 645-666
Author(s):  
Amit Shah ◽  
Kethesparan Paramesparan ◽  
Philip Robinson ◽  
Winston J. Rennie
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Health Care Cost ◽  
Clinical History ◽  
Soft Tissue Tumors ◽  
Tissue Mass ◽  
Imaging Characteristics ◽  
Pictorial Review ◽  
Neoplastic Process ◽  
Tumor Like Lesions

AbstractClinicians are commonly faced with patients presenting with a solitary palpable soft tissue mass. Most soft tissue lesions are benign, and not every mass is due to a neoplastic process. Many pathologies can mimic a malignant tumor. Despite appropriate clinicoradiologic assessment, these lesions can be mistaken for a soft tissue sarcoma and can lead to multiple investigations or an intervention, inconveniencing patients and leading to an increased health care cost. With the relevant clinical history, clinical examination, and specific imaging characteristics, the diagnosis can be narrowed. We present a pictorial review of soft tissue sarcoma mimics with guidance on appropriate differential diagnoses.

Nodular Fasciitis: Differential Considerations and Current Management Strategies

2009 ◽  
Vol 75 (7) ◽  
pp. 610-614 ◽  
Author(s):  
Stephen R. Grobmyer ◽  
Jacquelyn A. Knapik ◽  
Robin M. Foss ◽  
Edward M. Copeland ◽  
Steven N. Hochwald
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Breast Implant ◽  
Correct Diagnosis ◽  
Recent Experience ◽  
Nodular Fasciitis ◽  
Tissue Mass ◽  
Complete Excision ◽  
Soft Tissue Sarcoma Patient ◽  
Imaging Characteristics

Nodular fasciitis (NF) typically presents as an enlarging soft tissue mass with imaging characteristics that may be suggestive of soft tissue sarcoma or desmoid tumor. This presentation can make a correct diagnosis and management of patients with NF a challenge. We report our recent experience with two cases of NF that were both referred with a diagnoses of “soft tissue sarcoma.” Patient 1 was a 46-year-old woman who had undergone breast augmentation and was referred with a rapidly growing firm mass on the left chest wall beneath the breast implant. Computed tomography of the chest noted the mass to be 8 cm X 11 cm in size displacing the implant laterally with no radiological involvement of the bony structures of the chest. Core biopsy was suggestive of inflammation only. Given the clinical suspicion of malignancy, the patient underwent resection of the mass with implant removal. Final pathology showed NF. Patient 2 was a 65-year-old woman referred with an enlarging tender 3-cm infraclavicular mass and a clinical diagnosis of “soft tissue sarcoma.” Preoperative biopsy suggested NF. The patient underwent complete excision, which confirmed the diagnosis. These cases highlight the clinical issues associated with management of patients with NF. Current approaches to evaluation, diagnosis, and treatment of NF are discussed.

Color doppler ultrasonography of soft-tissue masses

1998 ◽  
Vol 39 (4) ◽  
pp. 421-426 ◽  
Author(s):  
R. Lagalla ◽  
A. Iovane ◽  
G. Caruso ◽  
M. Lo Bello ◽  
L. E. Derchi
Keyword(s):  
Soft Tissue ◽  
Doppler Ultrasonography ◽  
Color Doppler ◽  
Soft Tissue Tumors ◽  
Color Doppler Ultrasonography ◽  
Tissue Mass ◽  
Vascular Impedance ◽  
The Us ◽  
Soft Tissue Masses ◽  
Malignant Lesions

Purpose: To evaluate the capability of color Doppler ultrasonography to differentiate between benign and malignant soft-tissue tumors. Material and Methods: We reviewed the ultrasonographic (US) and color Doppler (CD) findings in 46 consecutive patients with a palpable periskeletal mass. The presence of 3 or more vascular hila and of tortuous and irregular internal vessels within the lesions was considered an indication of malignancy. The CD diagnosis was compared with that obtained at US alone. Results: The sensitivity and specificity of CD were respectively 85% and 92%; these values were higher than those obtained at US alone, respectively 75% and 50%. Arteriovenous malformations presented as lesions with large internal vessels that had low vascular impedance and were easily diagnosed. The waveform patterns within solid tumors were not specific. Conclusion: At present, US is commonly employed to confirm the presence of a suspected soft-tissue mass, to locate it accurately, and to indicate its nature. CD findings enhance the role of the US technique in such lesions. The combined use of US and CD can allow the differentiation of benign from malignant lesions, and thus provide a better basis for treatment.

MRI differentiation of low-grade and high-grade chondrosarcoma of the shoulder girdle, chest wall and pelvis: a pictorial review based on 111 consecutive cases

2021 ◽  
pp. 20201404
Author(s):  
Virendra Jain ◽  
Ines Oliveira ◽  
Anesh Chavda ◽  
Michael Khoo ◽  
Asif Saifuddin
Keyword(s):  
Soft Tissue ◽  
Chest Wall ◽  
Shoulder Girdle ◽  
Low Grade ◽  
High Grade ◽  
Tissue Mass ◽  
Cortical Destruction ◽  
Pictorial Review ◽  
Mri Features ◽  
Grade One

Approximately 40% of conventional chondrosarcomas arise from the shoulder girdle, chest wall and pelvis. This pictorial review describes the MRI features which may aid in the differentiation of Grade one chondrosarcoma (G1-CS) from high-grade chondrosarcoma (HG-CS) and dedifferentiated chondrosarcoma (DD-CS) in these locations, based on literature review and assessment of 111 consecutive cases presenting to the senior authors institution over a 13 year period. Of the 111 patients reviewed (71 males and 40 females; mean age 54.3 years; range 17–92 years), 27 were Gd1-CS, 72 were HG-CS and 12 were DD-CS. Tumours arising from the scapula, acetabulum, pubis/ischium and sacrum were more likely to be HG-CS, as were intra medullary tumours. MRI features associated with HG-CS and DD-CS included cortical destruction, bone oedema, soft tissue oedema, tumour necrosis, intermediate T2W SI and joint invasion. The presence of a soft tissue mass became a significant differentiating feature for tumours arising within the medullary cavity, but this was location specific and did not differentiate between Gd1-CS and HG-CS/DD-CS arising from the sternum or clavicle.

Evaluation of a Soft Tissue Mass in the Extremity or Trunk

2018 ◽  
Author(s):  
Daniel C Thomas ◽  
Dale Han
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Physical Examination ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Malignant Tumors ◽  
Soft Tissue Mass ◽  
Tissue Mass ◽  
Core Needle ◽  
Needle Tract

Soft tissue sarcoma (STS) represents a diverse group of malignant tumors derived from mesenchymal elements. Evaluation of a soft tissue mass of the trunk or extremity starts with a detailed history and physical examination, which will help guide further diagnostic evaluation.  Imaging should then be obtained for an STS, with MRI being the preferred modality for the trunk or extremities. Imaging can assist with diagnosis and delineate the extent of the primary lesion, including the relationship to contiguous structures, for treatment planning and assessing resectability. Pathology diagnosis is most commonly performed via examination of a specimen obtained through image-guided percutaneous core-needle biopsy. This requires multidisciplinary planning between Surgery and Radiology to place the needle within the anticipated definitive surgical incision to allow for en bloc resection of the needle tract. Once the diagnosis of an STS is made, appropriate staging studies should be performed based on the history and physical examination and tumor histology, grade, and size. Clinical and pathology data are used to stage STS patients using the American Joint Committee on Cancer staging system, which incorporates the STS site, size and grade of the primary tumor, and absence or presence of nodal and distant metastatic disease. This review contains 6 figures, 6 tables and 50 references Key words: core-needle biopsy, extremity, histology, imaging, risk factors, soft tissue mass, soft tissue sarcoma, staging evaluation, trunk, tumor grade

Diagnosis and Management of Genitourinary Rhabdomyosarcoma

2019 ◽  
Author(s):  
Ahmed Abdelhalim ◽  
Zhan Tao (Peter) Wang ◽  
Ali Nael ◽  
Antoine E Khoury
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Risk Stratification ◽  
Collaborative Study ◽  
Tumor Biology ◽  
Study Groups ◽  
Soft Tissue Tumors ◽  
Tumor Surveillance ◽  
Future Developments ◽  
International Collaborative Study

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children. Genitourinary RMS accounts for 15 to 25% of all RMSs and is a heterogeneous group of soft tissue tumors that vary in presentation, distribution, and prognosis. This article reviews the pathophysiology and tumor biology of RMS. It will also describe the initial approach to its diagnosis and current tumor surveillance protocols. Furthermore, this article presents the evidence behind a number of different staging and risk stratification systems currently used to guide treatment. Lastly, this article reviews future developments of investigational studies and risk stratification under investigation by a number of large international collaborative study groups. This review contains 17 figures, 7 tables, and 68 references. Keywords:  Rhabdomyosarcoma, genitourinary, staging, diagnosis, paratesticular, bladder, prostate, RMS

Adipocyte-rich CTNNB1-mutated Intramuscular Gardner Fibroma Progressing to Desmoid Fibromatosis

2020 ◽  
pp. 109352662096880
Author(s):  
Andrea Bakker ◽  
Jonathan C Slack ◽  
Mara Caragea ◽  
Kyle C Kurek ◽  
Marie-Anne Bründler
Keyword(s):  
Soft Tissue ◽  
Soft Tissue Tumor ◽  
Soft Tissue Tumors ◽  
Molecular Testing ◽  
Tissue Mass ◽  
Desmoid Fibromatosis ◽  
Benign Soft Tissue Tumor ◽  
First Time ◽  
Generation Sequencing

Gardner fibroma (GF) is a benign soft-tissue tumor that is associated with Gardner syndrome and can progress to, or co-occur with, desmoid fibromatosis (DF). Herein, we report a unique case of an 11-year-old boy who presented with a rapidly growing soft-tissue mass after biopsy of a stable fat-rich lesion present in the calf muscles since infancy, with Magnetic resonance imaging findings suggesting an intramuscular adipocytic tumor. The resection showed GF and DF. DF arising from a preexisting GF (the so-called “GF-DF sequence”) is a well-documented phenomenon. Although immunohistochemistry was negative for nuclear β-catenin expression, a CTTNB1 S45F mutation, which has been associated with aggressive behavior in DF, was identified in both components using a next-generation sequencing-based molecular assay. This is the first time a mutation in CTNNB1 has been identified in GF and the GF–DF sequence, thus expanding our knowledge of the molecular pathogenesis of the GF–DF sequence and highlighting the role of molecular testing in pediatric soft-tissue tumors. The histologic findings of an adipocyte-rich intramuscular GF also are unique, expanding the morphological spectrum of GF and adding GF to the differential diagnosis of intramuscular lesions with an adipocytic component.

scholarly journals Magnetic Resonance Imaging Appearance of Schwannomas from Head to Toe: A Pictorial Review

2017 ◽  
Vol 7 ◽  
pp. 38 ◽  
Author(s):  
Jamie Crist ◽  
Jacob R Hodge ◽  
Matthew Frick ◽  
Fiona P Leung ◽  
Eugene Hsu ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Tissue ◽  
Neurofibromatosis Type ◽  
Soft Tissue Tumors ◽  
The Body ◽  
Resonance Imaging ◽  
Pictorial Review ◽  
Benign Soft Tissue Tumors ◽  
Mri Characteristics

Schwannomas are benign soft-tissue tumors that arise from peripheral nerve sheaths throughout the body and are commonly encountered in patients with neurofibromatosis Type 2. The vast majority of schwannomas are benign, with rare cases of malignant transformation reported. In this pictorial review, we discuss the magnetic resonance imaging (MRI) appearance of schwannomas by demonstrating a collection of tumors from different parts of the body that exhibit similar MRI characteristics. We review strategies to distinguish schwannomas from malignant soft-tissue tumors while exploring the anatomic and histologic origins of these tumors to discuss how this correlates with their imaging findings. Familiarity with the MRI appearance of schwannomas can help aid in the differential diagnosis of soft-tissue masses, especially in unexpected locations.

Soft-Tissue Tumors of the Hand—Imaging Features

2020 ◽  
Vol 71 (2) ◽  
pp. 161-173 ◽  
Author(s):  
Gregory Scott Stacy ◽  
Jeffrey Bonham ◽  
Anthony Chang ◽  
Stephen Thomas
Keyword(s):  
Soft Tissue ◽  
Daily Practice ◽  
Soft Tissue Tumors ◽  
Vascular Lesions ◽  
Imaging Features ◽  
Imaging Studies ◽  
Adipocytic Tumors ◽  
Imaging Characteristics ◽  
Tumors Of The Hand ◽  
Structured Approach

Imaging studies of the hands and fingers are common, and radiologists are generally comfortable with traumatic and degenerative conditions which arise frequently in daily practice. However, a variety of common and uncommon soft-tissue tumors also occur in the hand, the appropriate diagnosis of which can be a source of confusion for both clinicians and radiologists. These lesions often have overlapping imaging characteristics; however, a structured approach can help provide a focused differential diagnosis and impact further workup and management. We discuss several such tumors, categorizing them as cystic-appearing, noncystic masses along tendons and aponeuroses, adipocytic tumors, vascular lesions, and miscellaneous lesions with imaging features that can aid diagnosis.

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