Learning objectives
Soft-tissue sarcomas are rare tumors that can affect any age,
gender,
and anatomic subsite. The extremities are the site of 50% of soft-tissue sarcomas,
with 80% of those occurring in the lower extremities.
The natural history in this location is often characterized by large size at presentation despite slow growth owing to delay in diagnosis.
Local control and survival vary according to anatomic site,
largely because resection is less feasible and radiation therapy less easily administered in some regions.
Background
The aim of this review is to analyse the spectrum of radiological signs as reported in the recent literature,
in light of our series over a 5-year period,
to pinpoint the most common radiological signs and to determine the role played by each techinique in order to establish a proper diagnosis.
Imaging findings OR Procedure Details
Pathology
N°
%
Synovial sarcoma
20
17%
Myxofibrosarcoma
17
14%
Spindle cell sarcoma
16
13%
Clear cell sarcoma
8
7%
Leiomyosarcoma
8
7%
Extraskeletal myxoid chondrosarcoma (EMCS)
6
5%
Malignant peripheral nerve sheath tumor (MPNST)
6
5%
Liposarcoma
6
5%
Angiosarcoma
6
5%
Ewing sarcoma
5
4%
Pleomorphic sarcoma
5
4%
Alveolar rhabdomyosarcoma
5
4%
Myxoinflammatory fibroblastic sarcoma
4
3%
Epithelioid sarcoma
2
2%
Small round cell sarcoma
2
2%
Pseudomyogenic haemangioendothelioma
1
1%
Dermatofibrosarcoma protuberans
1
1%
Sclerosing rhabdomyosarcoma
1
1%
Kaposi sarcoma
1...
Conclusion
Sarcomas are rare in the foot.
Correlation between radiology (confirming the tissue of origin and likely diagnosis based on morphology and signal) and pathology is vital for accurate diagnosis as biopsies may be small and management options limited.
References
Oncodiagnosis panel: 2007: multidisciplinary management ofsoft-tissue sarcoma.
Robinson E,
Bleakney RR,
Ferguson PC,
O'Sullivan B.
Radiographics.
2008 Nov-Dec;28(7):2069-86.
Personal Information
Dr Luigi Pedone
Resident Radiologist
Policlinico "A.Gemelli" - Roma
email:
[email protected]