Learning objectives
To describe the clinical presentation,
the epidemiology and the histopathological features of Myxoid Liposarcoma
To review the US and MRI appearance of this disease
To illustrate the differential diagnosis with Myxoma
Background
Liposarcoma is the second most common of soft-tissue sarcomas,
accounting for 14%–18% of these lesions (1,
2,
3). Liposarcoma originates from primitive mesenchimal cells and is classified into five histological subtypes: well differented,
myxoid,
de-diffrented,
pleomorphic and mixed.
The prognosis of patients depends on the histological subtype (1,
4).
Myxoid Liposarcoma is the second common type of Liposarcoma and occurs most commonly in the lower extremities,
particularly the thigh: they are most frequently intermuscular or subcutaneous lesions (1,
4,).
Other localizations are upper extremities and...
Findings and procedure details
Sonographic features of Myxoid Liposarcoma are not been extensively reported: US shows a hypo-echoic,
solid,
ovalar and well-defined mass (4).
Doppler US analysis reveals predominant a peripheral vascularization (in some cases is observed a vascular peduncle penetrating into the lesion) [Fig.2].
This appearance may be similar to Lipoma,
the most common benign tumor of soft-tissues,
composed of mature adipocytes (10).
Usually,
Lipoma is a hyperechoic and encapsulated lesion; however,
in the 20% of patient,
Lipoma appears hypoechoic with minimal color-Doppler flow (11).
Myxoid Liposarcoma has...
Conclusion
Myxoid Liposarcoma is a rare malignant tumor but it must be considered in the differential diagnoses of soft-tissue palpable masses.
It requires a timely diagnosis for establishing the most appropriate therapeutic program.
Furthermore,
it is extremely important to know the several types of soft-tissue tumors,
their clinical presentation,
most common localization and the affected age range.
Gadolinium-enhanced MRI recognizes the suspicious nature of a soft-tissue lesion and directs to the most probably diagnostic hypothesis.
Personal information
Fischetti Aldo: Scuola di Specializzazione Radiodiagnostica,
Università di Genova (
[email protected])
Ilaria Mussetto: Scuola di Specializzazione Radiodiagnostica,
Università di Genova
Romano Nicola: Scuola di Specializzazione Radiodiagnostica,
Università di Genova
Bianchi Rita: Scuola di Specializzazione Anatomia Patologica,
Università di Genova
Rosselli Giuliana: Azienda Ospedaliera Universitaria Careggi Firenze
Muda Alessandro: IRCCS San Martino- IST Genova
References
1.
Mi-Sook Sung,
MD; Heong S.
Kang,
MD; Jin S.
Suh,
MD; Jung H.
Lee,
MD; Jeong M.
Park,
MD; Jee Y.
Kim,
MD; Hae G.
Lee,
MD.
Myxoid Liposarcoma: Appearance at MR Imaging with Histologic Correlation.
2.
Evans HL.
Liposarcomas and atypical lipomatous tumors: a study of 66 cases followed for a minimum of 10 years.
Surg Pathol 1988; 1:41–54.
3.
Kransdorf MJ.
Malignant soft tissue tumors in a large referral population: distribution of diagnoses by age,
sex,
and location.
AJR Am J Roentgenol...