Peripheral soft tissue Ewing’s sarcoma: a rare case report

A 22 years male patient presented with gradual left forearm swelling for 6 months. X ray forearm revealed large soft tissue swelling with tiny calcification and mild scalloping at inner aspect of ulna and ultrasonogram (USG) revealed soft tissue mass having calcification and necrotic areas within and spectral Doppler showed arterial type of blood flow with no augmentation. Later computerized tomography (CT) scan showed soft tissue mass with necrotic area and calcification with no bony involvement. Magnetic resonance imaging (MRI) with contrast revealed a large heterogeneously enhancing lobulated mixed intensity lesion in antero-medial compartment of the left forearm involving flexor group of muscles causing displacement of fat plane. MRI and subsequent histopathology of the lesion revealed it as a rare soft tissue Ewings sarcoma / primitive neuroectodermal tumor (PNET) in extremity. DOI: http://dx.doi.org/10.3329/imcj.v7i2.20113 Ibrahim Med. Coll. J. 2013; 7(2): 43-46

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Dual-Energy X-Ray Absorptiometry-Measured Lean Soft Tissue Mass: Differing Relation to Body Cell Mass Across the Adult Life Span

The Journals of Gerontology Series A ◽

10.1093/gerona/59.8.b796 ◽

2004 ◽

Vol 59 (8) ◽

pp. B796-B800 ◽

Cited By ~ 26

Author(s):

M.-P. St-Onge ◽

J. Wang ◽

W. Shen ◽

Z. Wang ◽

D. B. Allison ◽

...

Keyword(s):

Soft Tissue ◽

Life Span ◽

Soft Tissue Mass ◽

Cell Mass ◽

Adult Life ◽

Dual Energy ◽

Body Cell Mass ◽

Tissue Mass ◽

Adult Life Span ◽

X Ray

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Monophasic Synovial Sarcoma Presenting as Infantile Hemangioma: A Case Report

10.21203/rs.3.rs-69264/v1 ◽

2020 ◽

Author(s):

Abdulrahman Fahad Al Kandari ◽

Abdulwahab Fahad Alkandari ◽

Sarah Faisal Alhendi ◽

Hussain Saleh Almousawi ◽

Hisham Adel Burezq

Keyword(s):

Case Report ◽

Soft Tissue ◽

Synovial Sarcoma ◽

Clinical Features ◽

Beta Blocker ◽

Soft Tissue Mass ◽

Infantile Hemangioma ◽

Left Forearm ◽

Tissue Mass ◽

Blocker Therapy

Abstract Objective: This report describes a case of a monophasic synovial sarcoma that was initially misdiagnosed as an infantile hemangioma in a 3-month-old female infant. We also discuss the basic elements of evaluating a soft-tissue mass and important radiological and clinical features that should raise the index of suspicion for a synovial sarcoma. Summary Background Data: Synovial sarcoma is a rare pathology that is often challenging to diagnose due to its similarities with more common vascular lesions that occur in infancy. Infantile hemangioma, in particular, is common, has distinctive clinical and radiological findings, and is frequently diagnosed without histological confirmation. This increases the risk of misdiagnosis of rare tumors in infancy. Case Report: A 3-month-old female infant presented with a soft-tissue mass on the left forearm. Physical examination showed a well-defined, subcutaneous mass on the left forearm, measuring approximately 3 cm × 5 cm, firm in consistency, with no cutaneous involvement and normal skin coverage. Imaging suggested an infantile hemangioma but, due to the atypical presentation, a trial of beta-blocker therapy was conducted to confirm the diagnosis. The patient showed no clinical response to beta-blocker therapy, and therefore an incisional biopsy was performed. Using histopathology, the tumor was diagnosed as a monophasic synovial sarcoma.Conclusions: We highlight a rare presentation of a synovial sarcoma in a neonate and caution against making a diagnosis without histopathologic analysis. Clinicians should include sarcoma in the differential diagnosis when assessing a mass in neonates, as early diagnosis and intervention can reduce morbidity and mortality.MINI ABSTRACT A 3-month-old infant presented with a left forearm soft-tissue mass, initially diagnosed as infantile hemangioma. Biopsy revealed a monophasic synovial sarcoma. We discuss the basic elements of evaluating a soft-tissue mass and important radiological and clinical features that should raise the index of suspicion for a synovial sarcoma.

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Diagnostic value of MRI signs in differentiating Ewing sarcoma from osteomyelitis

Acta Radiologica ◽

10.1177/0284185118774953 ◽

2018 ◽

Vol 60 (2) ◽

pp. 204-212 ◽

Cited By ~ 1

Author(s):

Ömer Kasalak ◽

Jelle Overbosch ◽

Hugo JA Adams ◽

Amelie Dammann ◽

Rudi AJO Dierckx ◽

...

Keyword(s):

Soft Tissue ◽

Transition Zone ◽

Ewing Sarcoma ◽

Soft Tissue Mass ◽

Characteristic Curve ◽

Bone Lesion ◽

Diagnostic Value ◽

Observer Agreement ◽

Tissue Mass ◽

Magnetic Resonance Imaging Mri

Background The value of magnetic resonance imaging (MRI) signs in differentiating Ewing sarcoma from osteomyelitis has not be thoroughly investigated. Purpose To investigate the value of various MRI signs in differentiating Ewing sarcoma from osteomyelitis. Material and Methods Forty-one patients who underwent MRI because of a bone lesion of unknown nature with a differential diagnosis that included both Ewing sarcoma and osteomyelitis were included. Two observers assessed several MRI signs, including the transition zone of the bone lesion, the presence of a soft-tissue mass, intramedullary and extramedullary fat globules, and the penumbra sign. Results Diagnostic accuracies for discriminating Ewing sarcoma from osteomyelitis were 82.4% and 79.4% for the presence of a soft-tissue mass, and 64.7% and 58.8% for a sharp transition zone of the bone lesion, for readers 1 and 2 respectively. Inter-observer agreement with regard to the presence of a soft-tissue mass and the transition zone of the bone lesion were moderate (κ = 0.470) and fair (κ = 0.307), respectively. Areas under the receiver operating characteristic curve of the diameter of the soft-tissue mass (if present) were 0.829 and 0.833, for readers 1 and 2 respectively. Mean inter-observer difference in soft-tissue mass diameter measurement ± limits of agreement was 35.0 ± 75.0 mm. Diagnostic accuracies of all other MRI signs were all < 50%. Conclusion Presence and size of a soft-tissue mass, and sharpness of the transition zone, are useful MRI signs to differentiate Ewing sarcoma from osteomyelitis, but inter-observer agreement is relatively low. Other MRI signs are of no value in this setting.

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Lean Soft Tissue Mass Measured Using Dual-Energy X-Ray Absorptiometry Is an Effective Index for Assessing Change in Leg Skeletal Muscle Mass Following Exercise Training

Journal of Clinical Densitometry ◽

10.1016/j.jocd.2018.03.008 ◽

2018 ◽

Vol 21 (3) ◽

pp. 394-398 ◽

Cited By ~ 6

Author(s):

Taishi Midorikawa ◽

Megumi Ohta ◽

Suguru Torii ◽

Shizuo Sakamoto

Keyword(s):

Skeletal Muscle ◽

Soft Tissue ◽

Exercise Training ◽

Muscle Mass ◽

Skeletal Muscle Mass ◽

Soft Tissue Mass ◽

Dual Energy ◽

Effective Index ◽

Tissue Mass ◽

X Ray

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Measurement of Changes in Soft Tissue Mass and Fat Mass with Weight Change: Pencil- versus Fan-Beam Dual-Energy X-ray Absorptiometry

Annals of the New York Academy of Sciences ◽

10.1111/j.1749-6632.2000.tb06426.x ◽

2006 ◽

Vol 904 (1) ◽

pp. 94-97 ◽

Cited By ~ 12

Author(s):

F. A. TYLAVSKY ◽

T. FUERST ◽

M. NEVITT ◽

M. DOCKRELL ◽

J. Y. WAN ◽

...

Keyword(s):

Soft Tissue ◽

Fat Mass ◽

Weight Change ◽

Soft Tissue Mass ◽

Dual Energy ◽

Tissue Mass ◽

X Ray

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Madura Foot that Presented like Soft Tissue Sarcoma

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.36883 ◽

2021 ◽

Vol 9 (VII) ◽

pp. 2293-2296

Author(s):

Zahra Ebrahim Jahromi

Keyword(s):

Soft Tissue ◽

Soft Tissue Mass ◽

Three Dimensional ◽

Infectious Agent ◽

Farm Animals ◽

Western Region ◽

Tissue Mass ◽

X Ray ◽

History Of ◽

Madura Foot

79 years old female agricultural worker in a farm gardening and taking care of farm animals from Al- Baha western region in Saudi Arabia presented with a 7-year history of left plantar foot soft tissue mass. According to the patient, the swelling had gradually increased in size over a few years, but it was painless and thus had not restricted him from continuing to farm until the lesion started to affect mobility. An X-ray, MRI, and histopathology reported a rare infectious agent Antinomies spp, otherwise referred to as Madura foot. Three-dimensional CT aided in a preoperative surgical plan which included mass excision/ debunking for this challenging lesion. Patient required prolonged anti-infective therapy (> 4 months) after follow the patient improved and not has any pain or recurrence of lesion or infection.

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Musculoskeletal Soft-Tissue Sarcoma: Quality Assessment of Initial MRI Reports Shows Frequent Deviation from ESSR Guidelines

Diagnostics ◽

10.3390/diagnostics11040695 ◽

2021 ◽

Vol 11 (4) ◽

pp. 695

Author(s):

Sebastian Weiss ◽

Alexander Korthaus ◽

Nora Baumann ◽

Jin Yamamura ◽

Alexander S. Spiro ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcomas ◽

Quality Criteria ◽

Final Diagnosis ◽

Tissue Mass ◽

Musculoskeletal Radiology ◽

Radiology Reports ◽

Patients At Risk ◽

Magnetic Resonance Imaging Mri ◽

The Masses

Soft-tissue sarcomas (STS) are a rare subtype of soft-tissue mass and are frequently misinterpreted as benign lesions. Magnetic resonance imaging (MRI) is the primary recommended type of diagnostics. To assess the quality of primary radiology reports, we investigated whether recommended MRI report elements were included in compliance with European Society of Musculoskeletal Radiology (ESSR) guidelines. A total of 1107 patients were evaluated retrospectively, and 126 radiological reports on patients with malignant STS were assessed for ESSR quality criteria. One or more required sequences or planes were missing in 67% of the reports. In all 126 cases, the report recognized the mass as anomalous (100%). Sixty-eight percent of the reports mentioned signs of malignancy. The majority of reports (n = 109, 87%) articulated a suspected diagnosis, 32 of which showed a mismatch with the final diagnosis (25%). Thirty-two percent of the reports had a misinterpretation of the masses as benign. Benign misinterpretations were more common in masses smaller than 5 cm (65% vs. 27%). Thirty percent of the reports suggested tissue biopsy and 6% recommended referral to a sarcoma center. MRI reports showed frequent deviations from ESSR guidelines, and protocol guidelines were not routinely met. Deviations from standard protocol and reporting guidelines could put patients at risk for inadequate therapy.

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