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Published in: Skeletal Radiology 1/2018

01-01-2018 | Case Report

Undifferentiated pleomorphic sarcoma: indolent, tail-like recurrence of a high-grade tumor

Authors: Justin S. Alpert, Patrick Boland, Meera Hameed, David M. Panicek

Published in: Skeletal Radiology | Issue 1/2018

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Abstract

Recurrence of a soft tissue sarcoma typically manifests as a round or oval mass at imaging, and recurrent high-grade soft tissue sarcomas generally enlarge relatively rapidly. We present a case of high-grade undifferentiated pleomorphic sarcoma in the calf of a 48-year-old male that recurred as a thin, curvilinear “tail” of enhancing tissue at magnetic resonance imaging (MRI), with extremely indolent growth over a 7-year period. The unusual imaging finding of a slowly enlarging “tail” should not be dismissed as postoperative changes, even for a high-grade soft tissue sarcoma.
Literature
1.
go back to reference Jo V, Fletcher C. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology. 2014;46(2):95–104.CrossRefPubMed Jo V, Fletcher C. WHO classification of soft tissue tumours: an update based on the 2013 (4th) edition. Pathology. 2014;46(2):95–104.CrossRefPubMed
2.
go back to reference Yoo HJ, Hong SH, Kang Y, Choi JY, Moon KC, Kim HS, et al. MR imaging of myxofibrosarcoma and undifferentiated sarcoma with emphasis on tail sign; diagnostic and prognostic value. Eur Radiol. 2014;24:1749–57.CrossRefPubMed Yoo HJ, Hong SH, Kang Y, Choi JY, Moon KC, Kim HS, et al. MR imaging of myxofibrosarcoma and undifferentiated sarcoma with emphasis on tail sign; diagnostic and prognostic value. Eur Radiol. 2014;24:1749–57.CrossRefPubMed
3.
go back to reference Daigler A, Zmarsly I, Hirsch T, Goertz O, Steinau HU, Lehnhardt M, et al. Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma. Br J Cancer. 2014;110(6):1456–64.CrossRef Daigler A, Zmarsly I, Hirsch T, Goertz O, Steinau HU, Lehnhardt M, et al. Long-term outcome after local recurrence of soft tissue sarcoma: a retrospective analysis of factors predictive of survival in 135 patients with locally recurrent soft tissue sarcoma. Br J Cancer. 2014;110(6):1456–64.CrossRef
4.
go back to reference Gibbs JF, Huang PP, Lee RJ, McGrath B, Brooks J, McKinley B, et al. Malignant fibrous histiocytoma: an institutional review. Cancer Investig. 2001;19(1):23–7.CrossRef Gibbs JF, Huang PP, Lee RJ, McGrath B, Brooks J, McKinley B, et al. Malignant fibrous histiocytoma: an institutional review. Cancer Investig. 2001;19(1):23–7.CrossRef
5.
go back to reference Steen S, Stephenson G. Current treatment of soft tissue sarcoma. Proc (Baylor Univ Med Cent). 2008;21(4):392–6. Steen S, Stephenson G. Current treatment of soft tissue sarcoma. Proc (Baylor Univ Med Cent). 2008;21(4):392–6.
6.
go back to reference Huang HY, Lal P, Qin J, Brennan M, Antonescu C. Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of 3-tier and 4-tier grading systems. Hum Pathol. 2004;35(5):612–21.CrossRefPubMed Huang HY, Lal P, Qin J, Brennan M, Antonescu C. Low-grade myxofibrosarcoma: a clinicopathologic analysis of 49 cases treated at a single institution with simultaneous assessment of the efficacy of 3-tier and 4-tier grading systems. Hum Pathol. 2004;35(5):612–21.CrossRefPubMed
7.
go back to reference Haglund KE, Raut CP, Nascimento AF, Wang Q, George S, Baldini EH. Recurrence patterns and survival for patients with intermediate- and high-grade myxofibrosarcoma. Int J Radiat Oncol Biol Phys. 2012;82(1):361–7.CrossRefPubMed Haglund KE, Raut CP, Nascimento AF, Wang Q, George S, Baldini EH. Recurrence patterns and survival for patients with intermediate- and high-grade myxofibrosarcoma. Int J Radiat Oncol Biol Phys. 2012;82(1):361–7.CrossRefPubMed
8.
go back to reference Waters B, Panicek D, Lefkowitz R, Antonescu C, Healey J, Athanasian E, et al. Low-grade myxofibrosarcoma: CT and MRI patterns in recurrent disease. AJR Am J Roentgenol. 2007;188:W193–8.CrossRefPubMed Waters B, Panicek D, Lefkowitz R, Antonescu C, Healey J, Athanasian E, et al. Low-grade myxofibrosarcoma: CT and MRI patterns in recurrent disease. AJR Am J Roentgenol. 2007;188:W193–8.CrossRefPubMed
9.
go back to reference Chou SH, Hippe D, Lee A, Scherer K, Porrino J, Davidson D, et al. Gadolinium contrast enhancement improves confidence in diagnosing recurrent soft tissue sarcoma by MRI. Acad Radiol. 2017;24(5):615–22.CrossRefPubMed Chou SH, Hippe D, Lee A, Scherer K, Porrino J, Davidson D, et al. Gadolinium contrast enhancement improves confidence in diagnosing recurrent soft tissue sarcoma by MRI. Acad Radiol. 2017;24(5):615–22.CrossRefPubMed
10.
go back to reference Lefkowitz R, Landa J, Hwang S, Zabor E, Moskowitz C, Agaram N, et al. Myxofibrosarcoma: prevalence and diagnostic value of the “tail sign” on magnetic resonance imaging. Skelet Radiol. 2013;42:809–18.CrossRef Lefkowitz R, Landa J, Hwang S, Zabor E, Moskowitz C, Agaram N, et al. Myxofibrosarcoma: prevalence and diagnostic value of the “tail sign” on magnetic resonance imaging. Skelet Radiol. 2013;42:809–18.CrossRef
Metadata
Title
Undifferentiated pleomorphic sarcoma: indolent, tail-like recurrence of a high-grade tumor
Authors
Justin S. Alpert
Patrick Boland
Meera Hameed
David M. Panicek
Publication date
01-01-2018
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology / Issue 1/2018
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-017-2778-3

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