Metastatic myxoid liposarcomas: imaging and histopathologic findings
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SCIENTIFIC ARTICLE
Metastatic myxoid liposarcomas: imaging and histopathologic findings Kenneth Sheah & Hugue A. Ouellette & Martin Torriani & G. Petur Nielsen & Susan Kattapuram & Miriam A. Bredella
Received: 24 September 2007 / Revised: 26 October 2007 / Accepted: 7 November 2007 / Published online: 21 December 2007 # ISS 2007
Abstract Objective The objective was to describe the imaging and histopathologic characteristics of metastatic myxoid liposarcomas. Materials and methods This retrospective study was approved by the institutional review board and complied with HIPAA guidelines. The study group comprised 12 patients with metastatic myxoid liposarcoma who underwent MRI, CT, or FDG-PET. The location and imaging characteristics of the metastatic lesions were recorded, and the histopathology of all metastatic lesions was reviewed. Results There were 23 histologically proven metastases in 12 patients. Based on imaging criteria, there were 41 metastases. The mean time from the diagnosis of primary tumor to the first metastasis was 4.4 years. Sixty-seven percent of patients had bone and soft tissue metastases, 33% had pulmonary metastases, 33% had liver metastases, 25% had intra-abdominal, and 16% retroperitoneal metastases. CT demonstrated well-defined lobulated masses with soft tissue attenuation in all cases, without macroscopic fat component. In cases of osseous metastases, CT showed mixed lytic and sclerotic foci, with bone destruction in advanced cases. MRI demonstrated fluidK. Sheah : H. A. Ouellette : M. Torriani : S. Kattapuram : M. A. Bredella (*) Department of Radiology, Massachusetts General Hospital, 55 Fruit Street, YAW 6E, Boston, MA 02114, USA e-mail: [email protected] K. Sheah Department of Radiology, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore G. P. Nielsen Department of Pathology, Massachusetts General Hospital, 55 Fruit Street, WRN235, Boston, MA 02114, USA
like signal intensity with mild heterogeneous enhancement in cases of soft tissue metastases. In osseous metastases, MRI showed avid heterogeneous enhancement. FDG-PET showed no significant FDG uptake for all metastases. MRI was the most useful imaging modality for osseous and soft tissue metastases. Conclusion Myxoid liposarcomas are soft tissue sarcomas, with a high prevalence of extrapulmonary metastases. The bones and soft tissues were the most common site of involvement, followed by the lungs and liver. MRI was the most sensitive modality in the detection of osseous and soft tissue metastases, and is the recommended modality for the diagnosis and follow-up of bone and soft tissue involvement. Keywords Myxoid liposarcoma . Metastasis . Magnetic resonance imaging . Positron emission tomography . Computed tomography
Introduction Liposarcoma is the second most common type of soft tissue sarcoma, after fibrohistiocytic sarcomas, and accounts for 10–35% of all soft tissue sarcomas [1, 2]. The World Health Organization (WHO) Committee for the Classification of Soft Tissue Tumors 2002 classification combined myx
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