Learning objectives
To familiarize radiologists with myriad ultrasound appearances of soft tissue lesions in relation to their MRI appearance.
To emphasize on uncommon and radiologically often undiagnosed soft tissue lesions.
To review the classification system and radiological findings of vascular anomalies,
soft tissue tumors and tumor like soft tissue lesions.
Background
Soft tissue lesions are commonly encountered in daily practice and are difficult to characterize on imaging.
Majority of the soft tissue lesions are benign.
Malignant soft tissue sarcoma accounts for less than 1% of overall soft tissue lesions.
The WHO has classified soft tissue tumours into 12 groups.
Each groups has four categories according to biological behaviour- benign,
intermediate (locally aggressive),
intermediate (rarely metastasizing) and maliganant.
Doppler ultrasound and MRI play an important role in the characterization of soft tissue lesions.
Doppler ultrasound has high...
Findings and procedure details
Abbreviated WHO classification of soft tissue tumors
Tumor groups
Benign
Malignant
Group 1
Adipocytic tumors
Lipoma
Liposarcoma
Group 2
Fibroblastic/ myofibroblastic tumor
Fibroma of tendon sheath
Fibrosarcoma
Group 3
Fibrohistiocytic tumor
Tenosynovial giant cell tumor
Group 4
Smooth muscle tumor
Leiomyoma
Leiomyosarcoma
Group 5
Pericytic/ perivascular tumor
Glomus tumor
-
Group 6
Skeletal muscle tumors
Rhabdomyoma
Rhabdomyosarcoma
Group 7
Vascular tumor
Hemangioma
Epithelioid hemangioendothelioma
Angiosarcoma
Group 8
Chondro-osseous tumors
Soft tissue chondroma
Mesenchymal chondrosarcoma
Extraskeletal osteosarcoma
Group 10
Peripheral nerve sheath tumors
Schwannoma
Neurofibroma
Malignant...
Conclusion
An extensive review of ultrasound and MRI appearances of soft tissue lesions focusing on uncommon and atypical ones would help radiologists to expand their knowledge of the same and accurately diagnose such lesions
This would help provide a non-invasive diagnosis of such lesions,
consequently improving patient management.
This would be expected to significantly reduce unnecessary biopsies in benign lesions and allow early diagnostic interventions and management in malignant or aggressive lesions,
thereby greatly improving prognosis and patient outcomes.
Personal information
Kavirajan Kabilan
Department of Radiodiagnosis
VMMC and Safdarjung Hospital
New Delhi
Abhilash Sethy
Department of Radiodiagnosis
VMMC and Safdarjung Hospital
New Delhi
Venkatram Krishnan
Department of Radiodiagnosis
VMMC and Safdarjung Hospital
New Delhi
Amita Malik
Department of Radiodiagnosis
VMMC and Safdarjung Hospital
New Delhi
Shishir Pansari
Department of Radiodiagnosis
VMMC and Safdarjung Hospital
New Delhi
References
Dinauer PA,
Brixey CJ,
Moncur JT,
Fanburg-Smith JC,
Murphey MD.
Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults.
Radiographics.2007;27(1):173-87.
Wang C,
Song R,
Kuang P,
Wang L,
Zhang M.
Giant cell tumor of the tendon sheath: Magnetic resonance imaging findings in 38 patients.
Oncol Lett.
2017;13(6):4459–62.
Petscavage-Thomas JM,
Walker EA,
Logie CI,
Clarke LE,Duryea DM,
Murphey MD.
Soft-tissue myxomatous lesions: Review of salient imaging features with pathologic comparison.
Radiographics.2014;34(4):964-80.
Murphey MD,
Gibson MS,
Jennings BT,
Crespo-Rodriguez AM,
Fanburg-Smith J,
Gajewski DA....