Learning objectives
To review the imaging characteristics of liposarcomas
To demonstrate the anatomy of abdominal wall defects through a case series of liposarcomas presenting clinically as hernias
Background
Liposarcomas are the most common soft tissue sarcomas which occur predominantly in the thigh or retroperitoneum in an adult. In this review we aim to highlight the role of cross-sectional imaging in the interrogation of lipomatous neoplastic masses which present as hernias.
Computed tomography (CT) and magnetic resonance (MR) imaging are vital modalities used in evaluating abdominal and pelvic disease and are essential tools in detecting tumours which in view of their size present by herniation through abdominal wall defects [1].
The late presentation of...
Imaging findings OR Procedure Details
Groin hernias:
1.
Indirect Inguinal hernia
A 50-year-old man presented with rapidly increasing abdominal distension,
abdominal pain,
and with a palpable mass in the groin (Fig 1).
Normal anatomy of the inguinal canal
The inguinal canal in the lower abdominal wall measures approximately 4 cm in length and is lined by the aponeuroses of the three abdominal muscles,
namely the external oblique,
internal oblique,
and transversus abdominis muscles.
The deep and superficial rings are openings at either end of this canal.
The deep ring in...
Conclusion
There are no specific imaging features to accurately distinguish the subtypes of lipomatous tumours radiologically.
Abdominal liposarcomas with a paucity of fat can be diagnostically challenging.
There are five distinct histologic subtypes of soft tissue liposarcomas: well differentiated,
dedifferentiated,
myxoid,
pleomorphic,
and mixed type.
Well differentiated liposarcomas present as a predominantly lipomatous mass with some non-lipomatous components in the form of thick septa or focal nodules.
A large nodular component suggests dedifferentiated liposarcoma,
and biopsy should be directed at this component.
Myxoid liposarcoma has a...
References
Priya R.
Bhosale,
Madhavi Patnana,
Chitra Viswanathan,
Janio Szklaruk,
A.
The Inguinal Canal: Anatomy and Imaging Features of Common and Uncommon Masses.
RadioGraphics 2008; 28:819–835
Aguirre DA,
Casola G,
Sirlin C.
Abdominal wall hernias: MDCT findings.
Am J Roentgenol.
2004;183(3):681-690.
doi:10.2214/ajr.183.3.1830681.
Lassandro F,
Iasiello F,
Pizza NL,
et al.
Abdominal hernias : Radiological features.
2011;3(6):110-117.
doi:10.4253/wjge.v3.i6.110.
P.
Oliveira,
A.
Salgado,
C.
Fernandes,
H.
Duarte,
R.
C.
Ramos,
S.
Dias,
M.
Gouvêa.
Abdominal liposarcoma revisited: CT and MR imaging findings with pathologic correlation.
ESR poster presentation....
Personal Information
Christine Azzopardi
Clinical Fellow at the Nuffield Orthopaedic Centre- Oxford University Hospitals
For questions and/or comments about this poster,
please contact me at:
[email protected]