Learning objectives
· To review the most common,
benign and malignant,
myxoid soft-tissue lesions.
· To mention other tumours that may contain myxomatous stroma among their components.
· To describe their behaviour in different imaging studies and imaging modalities of choice for characterisation.
Background
Myxoid soft-tissue tumours comprehend a wide group of mesenchymal neoplasms characterized by the production of abundant extracellular mucoid and myxoid matrix,
which consists of a gelatinous mucopolysaccharide matrix of sulphated and nonsulphated glycosaminoglycans and albumin.
These two components attract water from the adjacent blood vessels (Fig.
1); which stays trapped inside the lesion,
and is ultimately responsible for its cyst-like appearance in the different imaging techniques,
showing high-signal and extremely low-signal intensities at T2 and T1 weighted images in magnetic resonance (MR) respectively; low attenuation...
Findings and procedure details
Benign lesions:
The most common myxoid soft-tissue benign lesions are the intramuscular myxoma,
with no malignant potential,
and the aggressive angiomyxoma,
a locally aggressive entity.
1. Intramuscular myxoma:
It is a rare benign mesenchymal type of soft-tissue tumour which consists of an abundant myxoid stroma with bland undifferentiated stellate cells in it.
(Fig.
2) (Fig.
3) (Fig.
4) (Fig.
5)
It is said to have an approximate incidence of one case per million people,
affecting middle-aged women around 40-70 years.
Most of them are intramuscular...
Conclusion
Myxoid soft-tissue neoplasms comprehend a wide variety of tumours ranging from benign to malignant lesions,
with similar clinical and pathological features,
which can make diagnosis a real challenge.
Radiologists play an essential role in myxoid soft-tissue neoplasms diagnosis.
Therefore,
it is important to be acquaintance with the appearance of myxoid soft-tissue tumours in the different imaging studies,
emphasizing on specific imaging findings that may help differentiate benign and malignant lesions,
so as to narrow down the differential diagnosis and offer an accurate diagnosis if possible,...
References
1. Jonelle M.
Petscavage-Thomas,
MD,
MPH,
Eric A.
Walker,
MD,
Chika I.
Logie,
MD,
Loren E.
Clarke,
MD,
Dennis M.
Duryea,
DO,
Mark D.
Murphey,
MD; Soft-Tissue Myxomatous Lesions: Review of Salient Imaging features with Pathologic Comparison; Rdiographics; 34: 964-980; 2014
2. Akshay D.
Baheti,
Sree Harsha Tirumani,
Michael H.
Rosenthal,
Stephanie A.
Howard,
Atul B.
Shinagare,
Nikhil H.
Ramaiya and Jyothi P.
Jagannathan; Myxoid Soft-Tissue Neoplasm: Comprehensive Update of the Taxonomy and MRI Features; AJR 2015; 204: 374-385
3. Mi-Sook Sung,
MD,
Heong S....