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Type:
Educational Exhibit
Keywords:
Tissue characterisation, Neoplasia, Diagnostic procedure, Ultrasound, MR, Oncology, Musculoskeletal soft tissue
Authors:
L. Simbula1, A. De Marchi2, S. Pozza2, E. Brach del Prever2, D. Molino2, F. Cannone3, G. B. Meloni1, A. Borre2; 1Sassari/IT, 2Turin/IT, 3Catania/IT
DOI:
10.1594/ecr2015/C-1498
Background
Lipomatous tumors are common findings in ultrasound and magnetic resonance imaging and constitute half of all soft-tissue tumors in surgical series.
Among these tumors,
it can be difficult to distinguish simple lipomas from well-differentiated liposarcomas through imaging,
because they have got imaging similarities,
although histologically different.
Usually,
higher grade liposarcomas do not appear ambiguous in MRI because they typically contain little or no macroscopic fat1,2.
In accordance with World Health Organization,
the term “atypical lipoma” refers to subcutaneous extremity or trunk lesions which arise at surgically amenable locations.
The term “well differentiated liposarcoma” is used for lesions in all remaining sites,
but “well-differentiated liposarcoma” and “atypical lipoma” are pathologic synomyms,
rapresenting the lowest grade lesions in the spectrum of liposarcomas.
Unlike simple lipomas,
well-differentiated liposarcomas are characterized by a higher rate of local recurrence (from 0% to 50% for superficial extremity lesions,
from 43% to 69% for deep extremity lesions),
and can dedifferentiate becoming higher grade tumors1,2.
Because of this different behaviour,
a different treatment is provided,
well-differentiated liposarcomas requiring wider excision and long-term clinical follow-up.
So there’s the need to distinguish these lesions preoperatively.
Besides,
even a typical lipoma could lead to negative effects that must be recognized and pointed out by the radiological report,
such as effect of compression on peripheral nerves.