Skip to main content
Top
Published in: European Radiology 6/2009

Open Access 01-06-2009 | Musculoskeletal

Soft tissue sarcomas at a glance: clinical, histological, and MR imaging features of malignant extremity soft tissue tumors

Authors: M. van Vliet, M. Kliffen, G. P. Krestin, C. F. van Dijke

Published in: European Radiology | Issue 6/2009

Login to get access

Abstract

Soft tissue sarcomas comprise approximately 1% of malignant tumors. There are more than 50 subtypes, but pleomorphic sarcoma, liposarcoma, leiomyosarcoma, synovial sarcoma, and malignant peripheral nerve sheath tumor account for 75%. Differentiation between these subtypes is difficult because they often present with a painless enlarging mass, and share many histological and MR imaging features. Nonetheless, subdifferentiation is important because the different subtypes have different prognoses and therapeutic strategies. In this manuscript we discuss the clinical, histological, and MR imaging features of soft tissue sarcomas according to the WHO classification. An overview is provided and differentiating features are discussed that can help to narrow down the differential diagnosis.
Literature
1.
go back to reference Fletcher CDM, Unni KK, Mertens FE (eds) (2002) World Health Organization classification of tumors. Pathology and genetics of tumours of soft tissue and bone. IARC, Lyon Fletcher CDM, Unni KK, Mertens FE (eds) (2002) World Health Organization classification of tumors. Pathology and genetics of tumours of soft tissue and bone. IARC, Lyon
3.
4.
go back to reference Massengill AD, Seeger LL, Eckardt JJ (1995) The role of plain radiography, computed tomography, and magnetic resonance imaging in sarcoma evaluation. Hematol Oncol Clin North Am 9:571–604PubMed Massengill AD, Seeger LL, Eckardt JJ (1995) The role of plain radiography, computed tomography, and magnetic resonance imaging in sarcoma evaluation. Hematol Oncol Clin North Am 9:571–604PubMed
5.
go back to reference Weiss SW, Goldblum JR (eds) (2001) Enzinger and Weiss’s soft tissue tumors. Mosby, St Louis Weiss SW, Goldblum JR (eds) (2001) Enzinger and Weiss’s soft tissue tumors. Mosby, St Louis
6.
go back to reference Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT (2002) Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology 224:99–104PubMedCrossRef Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT (2002) Imaging of fatty tumors: distinction of lipoma and well-differentiated liposarcoma. Radiology 224:99–104PubMedCrossRef
7.
go back to reference Drevelegas A, Pilavaki M, Chourmouzi D (2004) Lipomatous tumors of soft tissue: MR appearance with histological correlation. Eur J Radiol 50:257–267PubMedCrossRef Drevelegas A, Pilavaki M, Chourmouzi D (2004) Lipomatous tumors of soft tissue: MR appearance with histological correlation. Eur J Radiol 50:257–267PubMedCrossRef
8.
go back to reference Barile A, Zugaro L, Catalucci A et al (2002) Soft tissue liposarcoma: histological subtypes, MRI and CT findings. Radiol Med (Torino) 104:140–149 Barile A, Zugaro L, Catalucci A et al (2002) Soft tissue liposarcoma: histological subtypes, MRI and CT findings. Radiol Med (Torino) 104:140–149
9.
go back to reference Murphey MD, Arcara LK, Fanburg-Smith J (2005) From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics 25:1371–1395PubMedCrossRef Murphey MD, Arcara LK, Fanburg-Smith J (2005) From the archives of the AFIP: imaging of musculoskeletal liposarcoma with radiologic-pathologic correlation. Radiographics 25:1371–1395PubMedCrossRef
10.
go back to reference De Schepper AM (ed) (2001) Imaging of soft tissue tumors, 2nd edn. Springer-Verlag, Berlin De Schepper AM (ed) (2001) Imaging of soft tissue tumors, 2nd edn. Springer-Verlag, Berlin
11.
12.
go back to reference Sung MS, Kang HS, Suh JS et al (2000) Myxoid liposarcoma: appearance at MR imaging with histologic correlation. Radiographics 20:1007–1019PubMed Sung MS, Kang HS, Suh JS et al (2000) Myxoid liposarcoma: appearance at MR imaging with histologic correlation. Radiographics 20:1007–1019PubMed
13.
go back to reference Munk PL, Sallomi DF, Janzen DL et al (1998) Malignant fibrous histiocytoma of soft tissue imaging with emphasis on MRI. J Comput Assist Tomogr 22:819–826PubMedCrossRef Munk PL, Sallomi DF, Janzen DL et al (1998) Malignant fibrous histiocytoma of soft tissue imaging with emphasis on MRI. J Comput Assist Tomogr 22:819–826PubMedCrossRef
14.
go back to reference Tateishi U, Kusumoto M, Hasegawa T, Yokoyama R, Moriyama N (2002) Primary malignant fibrous histiocytoma of the chest wall: CT and MR appearance. J Comput Assist Tomogr 26:558–563PubMedCrossRef Tateishi U, Kusumoto M, Hasegawa T, Yokoyama R, Moriyama N (2002) Primary malignant fibrous histiocytoma of the chest wall: CT and MR appearance. J Comput Assist Tomogr 26:558–563PubMedCrossRef
15.
go back to reference Wada T, Hasegawa T, Nagoya S, Kawaguchi S, Kaya M, Ishii S (2000) Myxofibrosarcoma with an infiltrative growth pattern: a case report. Jpn J Clin Oncol 30:458–462PubMedCrossRef Wada T, Hasegawa T, Nagoya S, Kawaguchi S, Kaya M, Ishii S (2000) Myxofibrosarcoma with an infiltrative growth pattern: a case report. Jpn J Clin Oncol 30:458–462PubMedCrossRef
16.
go back to reference Koh SH, Choe HS, Lee IJ, Park HR, Bae SH (2005) Low-grade fibromyxoid sarcoma: ultrasound and magnetic resonance findings in two cases. Skeletal Radiol 34:550–554PubMedCrossRef Koh SH, Choe HS, Lee IJ, Park HR, Bae SH (2005) Low-grade fibromyxoid sarcoma: ultrasound and magnetic resonance findings in two cases. Skeletal Radiol 34:550–554PubMedCrossRef
17.
go back to reference Christensen DR, Ramsamooj R, Gilbert TJ (1997) Sclerosing epithelioid fibrosarcoma: short T2 on MR imaging. Skeletal Radiol 26:619–621PubMedCrossRef Christensen DR, Ramsamooj R, Gilbert TJ (1997) Sclerosing epithelioid fibrosarcoma: short T2 on MR imaging. Skeletal Radiol 26:619–621PubMedCrossRef
18.
go back to reference Rechl H, Hof N, Gerdesmeier L (2001) (Differential diagnosis of bone and soft tissue tumors by MRI) Differentialdiagnostik von Knochen- und Weichteiltumoren in der MRT. Orthopade 30:528–539PubMedCrossRef Rechl H, Hof N, Gerdesmeier L (2001) (Differential diagnosis of bone and soft tissue tumors by MRI) Differentialdiagnostik von Knochen- und Weichteiltumoren in der MRT. Orthopade 30:528–539PubMedCrossRef
19.
go back to reference Mankin HJ, Casas-Ganem J, Kim JI, Gebhardt MC, Hornicek FJ, Zeegen EN (2004) Leiomyosarcoma of somatic soft tissues. Clin Orthop Relat Res:225–231 Mankin HJ, Casas-Ganem J, Kim JI, Gebhardt MC, Hornicek FJ, Zeegen EN (2004) Leiomyosarcoma of somatic soft tissues. Clin Orthop Relat Res:225–231
20.
go back to reference Kim EE, Valenzuela RF, Kumar AJ, Raney RB, Eftekari F (2000) Imaging and clinical spectrum of rhabdomyosarcoma in children. Clin Imaging 24:257–262PubMedCrossRef Kim EE, Valenzuela RF, Kumar AJ, Raney RB, Eftekari F (2000) Imaging and clinical spectrum of rhabdomyosarcoma in children. Clin Imaging 24:257–262PubMedCrossRef
21.
go back to reference Hagiwara A, Inoue Y, Nakayama T et al (2001) The “botryoid sign”: a characteristic feature of rhabdomyosarcomas in the head and neck. Neuroradiology 43:331–335PubMedCrossRef Hagiwara A, Inoue Y, Nakayama T et al (2001) The “botryoid sign”: a characteristic feature of rhabdomyosarcomas in the head and neck. Neuroradiology 43:331–335PubMedCrossRef
22.
go back to reference Van Rijn RR, Wilde JC, Bras J, Oldenburger F, McHugh KM, Merks JH (2008) Imaging findings in noncraniofacial childhood rhabdomyosarcoma. Pediatr Radiol 38:617–634PubMedCrossRef Van Rijn RR, Wilde JC, Bras J, Oldenburger F, McHugh KM, Merks JH (2008) Imaging findings in noncraniofacial childhood rhabdomyosarcoma. Pediatr Radiol 38:617–634PubMedCrossRef
23.
go back to reference Vilanova JC, Barcelo J, Smirniotopoulos JG et al (2004) Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics 24:367–385PubMedCrossRef Vilanova JC, Barcelo J, Smirniotopoulos JG et al (2004) Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics 24:367–385PubMedCrossRef
24.
go back to reference Nakazono T, Kudo S, Matsuo Y et al (2000) Angiosarcoma associated with chronic lymphedema (Stewart–Treves syndrome) of the leg: MR imaging. Skeletal Radiol 29:413–416PubMedCrossRef Nakazono T, Kudo S, Matsuo Y et al (2000) Angiosarcoma associated with chronic lymphedema (Stewart–Treves syndrome) of the leg: MR imaging. Skeletal Radiol 29:413–416PubMedCrossRef
25.
go back to reference Miyake M, Tateishi U, Maeda T, Arai Y, Hasegawa T, Sugimura K (2005) MR features of angiosarcoma in a patient with Maffucci’s syndrome. Radiat Med 23:508–512PubMed Miyake M, Tateishi U, Maeda T, Arai Y, Hasegawa T, Sugimura K (2005) MR features of angiosarcoma in a patient with Maffucci’s syndrome. Radiat Med 23:508–512PubMed
26.
go back to reference Vonderheide RH, Fleming MD, Carter G, Singer S, Demetri G (1997) Angiosarcoma. J Clin Oncol 15:1708–1709PubMed Vonderheide RH, Fleming MD, Carter G, Singer S, Demetri G (1997) Angiosarcoma. J Clin Oncol 15:1708–1709PubMed
27.
go back to reference Kajihara M, Sugawara Y, Hirata M et al (2005) Extraskeletal osteosarcoma in the thigh: a case report. Radiat Med 23:142–146PubMed Kajihara M, Sugawara Y, Hirata M et al (2005) Extraskeletal osteosarcoma in the thigh: a case report. Radiat Med 23:142–146PubMed
28.
go back to reference Dubec JJ, Munk PL, O’Connell JX et al (1997) Soft tissue osteosarcoma with telangiectatic features: MR imaging findings in two cases. Skeletal Radiol 26:732–736PubMedCrossRef Dubec JJ, Munk PL, O’Connell JX et al (1997) Soft tissue osteosarcoma with telangiectatic features: MR imaging findings in two cases. Skeletal Radiol 26:732–736PubMedCrossRef
29.
go back to reference Murphey MD, Gibson MS, Jennings BT, Crespo-Rodriguez AM, Fanburg-Smith J, Gajewski DA (2006) From the archives of the AFIP: Imaging of synovial sarcoma with radiologic-pathologic correlation. Radiographics 26:1543–1565PubMedCrossRef Murphey MD, Gibson MS, Jennings BT, Crespo-Rodriguez AM, Fanburg-Smith J, Gajewski DA (2006) From the archives of the AFIP: Imaging of synovial sarcoma with radiologic-pathologic correlation. Radiographics 26:1543–1565PubMedCrossRef
30.
go back to reference Tateishi U, Hasegawa T, Beppu Y, Satake M, Moriyama N (2004) Synovial sarcoma of the soft tissues: prognostic significance of imaging features. J Comput Assist Tomogr 28:140–148PubMedCrossRef Tateishi U, Hasegawa T, Beppu Y, Satake M, Moriyama N (2004) Synovial sarcoma of the soft tissues: prognostic significance of imaging features. J Comput Assist Tomogr 28:140–148PubMedCrossRef
31.
go back to reference Waldt S, Rechl H, Rummeny EJ, Woertler K (2003) Imaging of benign and malignant soft tissue masses of the foot. Eur Radiol 13:1125–1136PubMed Waldt S, Rechl H, Rummeny EJ, Woertler K (2003) Imaging of benign and malignant soft tissue masses of the foot. Eur Radiol 13:1125–1136PubMed
32.
go back to reference Nakanishi H, Araki N, Sawai Y et al (2003) Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation. Skeletal Radiol 32:701–707PubMedCrossRef Nakanishi H, Araki N, Sawai Y et al (2003) Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation. Skeletal Radiol 32:701–707PubMedCrossRef
33.
go back to reference Stacy GS, Nair L (2007) Magnetic resonance imaging features of extremity sarcomas of uncertain differentiation. Clin Radiol 62:950–958PubMedCrossRef Stacy GS, Nair L (2007) Magnetic resonance imaging features of extremity sarcomas of uncertain differentiation. Clin Radiol 62:950–958PubMedCrossRef
34.
go back to reference De Beuckeleer LH, De Schepper AM, Vandevenne JE et al (2000) MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases and literature review. Skeletal Radiol 29:187–195PubMedCrossRef De Beuckeleer LH, De Schepper AM, Vandevenne JE et al (2000) MR imaging of clear cell sarcoma (malignant melanoma of the soft parts): a multicenter correlative MRI-pathology study of 21 cases and literature review. Skeletal Radiol 29:187–195PubMedCrossRef
35.
go back to reference Hourani M, Khoury N, Mourany B, Shabb NS (2005) MR appearance of clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts): radiologic-pathologic correlation. Skeletal Radiol 34:543–546PubMedCrossRef Hourani M, Khoury N, Mourany B, Shabb NS (2005) MR appearance of clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts): radiologic-pathologic correlation. Skeletal Radiol 34:543–546PubMedCrossRef
36.
go back to reference Malchau SS, Hayden J, Hornicek F, Mankin HJ (2007) Clear cell sarcoma of soft tissues. J Surg Oncol 95:519–522PubMedCrossRef Malchau SS, Hayden J, Hornicek F, Mankin HJ (2007) Clear cell sarcoma of soft tissues. J Surg Oncol 95:519–522PubMedCrossRef
37.
go back to reference Chao KC, Chen C, Hsieh SC, Fang CL, Lao WT, Chan WP (2005) MRI of epithelioid sarcoma of the thigh. Clin Imaging 29:60–63PubMedCrossRef Chao KC, Chen C, Hsieh SC, Fang CL, Lao WT, Chan WP (2005) MRI of epithelioid sarcoma of the thigh. Clin Imaging 29:60–63PubMedCrossRef
38.
go back to reference Zevallos-Giampietri EA, Barrionuevo C (2005) Proximal-type epithelioid sarcoma: report of two cases in the perineum: differential diagnosis and review of soft tissue tumors with epithelioid and/or rhabdoid features. Appl Immunohistochem Mol Morphol 13:221–230PubMedCrossRef Zevallos-Giampietri EA, Barrionuevo C (2005) Proximal-type epithelioid sarcoma: report of two cases in the perineum: differential diagnosis and review of soft tissue tumors with epithelioid and/or rhabdoid features. Appl Immunohistochem Mol Morphol 13:221–230PubMedCrossRef
39.
go back to reference Suh JS, Cho J, Lee SH et al (2000) Alveolar soft part sarcoma: MR and angiographic findings. Skeletal Radiol 29:680–689PubMedCrossRef Suh JS, Cho J, Lee SH et al (2000) Alveolar soft part sarcoma: MR and angiographic findings. Skeletal Radiol 29:680–689PubMedCrossRef
40.
go back to reference Pang LM, Roebuck DJ, Griffith JF, Kumta SM, Metreweli C (2001) Alveolar soft-part sarcoma: a rare soft-tissue malignancy with distinctive clinical and radiological features. Pediatr Radiol 31:196–199PubMedCrossRef Pang LM, Roebuck DJ, Griffith JF, Kumta SM, Metreweli C (2001) Alveolar soft-part sarcoma: a rare soft-tissue malignancy with distinctive clinical and radiological features. Pediatr Radiol 31:196–199PubMedCrossRef
41.
go back to reference Vilanova JC, Woertler K, Narvaez JA et al (2007) Soft-tissue tumors update: MR imaging features according to the WHO classification. Eur Radiol 17:125–138PubMedCrossRef Vilanova JC, Woertler K, Narvaez JA et al (2007) Soft-tissue tumors update: MR imaging features according to the WHO classification. Eur Radiol 17:125–138PubMedCrossRef
Metadata
Title
Soft tissue sarcomas at a glance: clinical, histological, and MR imaging features of malignant extremity soft tissue tumors
Authors
M. van Vliet
M. Kliffen
G. P. Krestin
C. F. van Dijke
Publication date
01-06-2009
Publisher
Springer-Verlag
Published in
European Radiology / Issue 6/2009
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-008-1292-3

Other articles of this Issue 6/2009

European Radiology 6/2009 Go to the issue