Learning objectives
To present an algorithm for the approach of the soft tissue masses with magnetic resonance,
representative cases of frequent injuries and key points to define relevant differentials.
Background
INTRODUCTION
Soft tissue tumors are a complex group of lesions with wide differences between those ones.
The incidence of benign tumors is significantly higher with respect to malignant tumors (100: 1).
Soft tissue tumors can occur anywhere in the body,
mostly in the extremities (67% of cases),
chest wall and retroperitoneum.
Reference: Seminars of Roentgenology2010; 45(4): 277 – 297 andSurgical Oncology Clinics of North America2014; 23: 911 – 936.
WHO classification (2013):
Adipocytic tumors
Smooth muscle tumors
Skeletal muscle tumors
Nerve sheath tumors*
Chondro-osseous tumors...
Findings and procedure details
Role of the radiologist
Detection and confirmation of the mass.
Characterization (size,
location,
composition).
Differentiate benign,
indeterminate or potentially malignant lesions (usually in 75% to 90% of cases)
Determinate differential diagnoses.
Performing biopsies guided by images.
Staging and monitoring
GUIDELINES FOR DIAGNOSTIC.ACCORDING TO SIMPLES ALGORITMS AND SCHEMES
The first step is to evaluate the details of the clinical history necessary to rule out or increase the possibilities of differential diagnoses.
It is necessary to patients’ age,
lesion size,
location and multiplicity (Figures 3-7)
Figure 3....
Conclusion
The resonance is not specific to distinguish benign lesions from malignant ones but when the cases are analyzed in the light of the clinical data,
diagnostic possibilities can be suggested in the frame of: Benign appearance mass,
Aggressive appearance mass or Undetermined aspect mass.
If it can not characterize a mass it can be described with a series of suitable differentials.
But if the mass is not clearly benign,
it should be concluded as "indeterminate" and suggest a complementary histopathological study.
If every radiologist takes...
Personal information
Author Information:
Natalia Rueda Ruiz. Radiology Resident (Department of Imaging,
Fundación Santa Fe de Bogotá.
Radiology program of Universidad El Bosque.Bogotá,
Colombia).
Oscar Mauricio Rivero Rapalino. Radiologist Musculoskeletal imaging (Department of Imaging,
Fundación Santa Fe de Bogotá,Bogotá,
Colombia).
Andrés Ricardo Vásquez.Radiology Resident (Department of Imaging,
Fundación Santa Fe de Bogotá.
Radiology program of Universidad El Bosque.
Bogotá,
Colombia).
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