Abstract
Recognition of a soft tissue tumor on imaging, differentiation from a non-neoplastic soft tissue mass, and distinguishing benign from malignant soft tissue neoplasms are critical radiological skills yet prove to be pitfalls for many. Recognition of the characteristic imaging appearances of some of these conditions is crucial, and several of these are illustrated and described in this chapter. Appreciating the nonspecific nature of the imaging appearances of the remainder while ensuring that “nonspecific” means “could be malignant” to one’s clinical colleagues is the most important message of this chapter.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Anderson SE, Hertel R, Johnston JO et al (2005) Latissimus dorsi tendinosis and tear: imaging features of a pseudotumor of the upper limb in five patients. AJR Am J Roentgenol 185:1145–1151
Arkun R, Argin M (2014) Pitfalls in MR imaging of musculoskeletal tumors. Semin Musculoskelet Radiol 18:63–78
Bancroft LW, Kransdorf MJ, Peterson JJ, O’Connor MI (2006) Benign fatty tumors: classification, clinical course, imaging appearance, and treatment. Skeletal Radiol 35:719–733
Boutin RD, Fritz RC, Steinbach LS (2002) Imaging of sports-related muscle injuries. Radiol Clin N Am 40:333–362
Chaabane S, Chelli-Bouaziz M, Jelassi H et al (2008) Idiopathic tumoral calcinosis. Acta Orthop Belg 74:837–845
Chandrasekar CR, Grimer RJ, Carter SR et al (2008) Elastofibroma dorsi: an uncommon benign pseudotumor. Sarcoma. doi:10.1155/2008/756565
Chun CW, Jee WH, Park HJ et al (2010) MRI features of skeletal muscle lymphoma. AJR Am J Roentgenol 195:1355–1360
Chung WJ, Chung HW, Shin MJ et al (2012) MRI to differentiate benign from malignant soft-tissue tumors of the extremities: a simplified systematic imaging approach using depth, size and heterogeneity of signal intensity. Br J Radiol 85:e831–e836
Damron TA, Heiner J (2000) Distant soft tissue metastases: a series of 30 new patients and 91 cases from the literature. Ann Surg Oncol 7:526–534
De Schepper AM, Ramon FA, Degryse HR (1992) Statistical analysis of MRI parameters predicting malignancy in 141 soft tissue masses. Rofo 156:587–591
Delaney-Sathy LO, Fessel DP, Jacobson JA et al (2000) Sonography of diabetic muscle infarction with MR imaging, CT, and pathologic correlation. AJR Am J Roentgenol 174:165–169
Dhillon M, Davies AM, Benham J et al (2004) Calcific myonecrosis: a report of ten new cases with an emphasis on MR imaging. Eur Radiol 14:1974–1979
Dinauer PA, Brixey CJ, Moncur JT et al (2007) Pathologic and MR imaging features of benign fibrous soft-tissue tumors in adults. Radiographics 27:173–187
Escobar C, Munker R, Thomas JO et al (2011) Update on desmoid tumors. Ann Oncol 23:562–569
Fletcher CD, Unni KK, Mertens F (eds) (2002) WHO classification of tumors: pathology and genetics of tumors of soft tissue and bone. IARC, Lyon
Foreman KL, Kransdorf MJ, O’Connor MI, Krishna M (2013) AIRP best cases in radiologic-pathologic correlation: maffucci syndrome. Radiographics 33:861–868
Gaskill T, Payne D, Brigman B (2010) Cryptococcal abscess imitating a soft-tissue sarcoma in an immunocompetent host: a case report. J Bone Joint Surg Am 92:1890–1893
Goldblum JR, Folpe AL, Weiss SW (2013a) Benign fibroblastic/myofibroblatic proliferations, including superficial fibromatosis. In: Enzinger and Weiss’s soft tissue tumors, 6th edn. Elsevier Saunders, Philadelphia
Goldblum JR, Folpe AL, Weiss SW (2013b) Benign lipomatous tumors. In: Enzinger and Weiss’s soft tissue tumors, 6th edn. Elsevier Saunders, Philadelphia
Goodwin RW, O’Donnell P, Saifuddin A (2007) MRI appearances of common benign soft-tissue tumors. Clin Radiol 62:843–853
Grimer RJ (2006) Size matters for sarcomas. Ann R Coll Surg Engl 88:519–524
Havitcioglu H, Tatari H, Baran O et al (2003) Calcium pyrophosphate dihydrate crystal deposition disease mimicking malignant soft tissue tumor. Knee Surg Sports Traumatol Arthrosc 11:263–266
Huang GS, Lee CH, Chan WP et al (2003) Localized nodular synovitis of the knee: MR imaging appearance and clinical correlates in 21 patients. AJR Am J Roentgenol 181:539–543
Iwasko N, Steinbach LS, Disler D et al (2002) Imaging findings in Mazabraud’s syndrome: seven new cases. Skeletal Radiol 31:81–87
Jain V, Makwana GE, Bahri N et al (2012) The “dot in circle” sign on MRI in maduramycosis: a characteristic finding. J Clin Imaging Sci 2:66
Jonelle M, Petscavage-Thomas JM, Walker EA et al (2014) Soft-tissue myxomatous lesions: review of salient imaging features with pathologic comparison. Radiographics 34:964–980
Kapff PD, Hocken DB, Simpson RHW (1987) Elastofibroma of the hand. J Bone Joint Surg Br 69:468–469
Kato H, Kanematsu M, Watanabe H et al (2016) MR imaging findings of pilomatricomas: a radiological-pathological correlation. Acta Radiol 57:726–732
Kattapuram TM, Suri R, Rosol MS et al (2005) Idiopathic and diabetic skeletal muscle necrosis: evaluation by magnetic resonance imaging. Skeletal Radiol 34:203–209
Keppler-Noreuil KM, Sapp JC, Lindhurst MJ et al (2014) Clinical delineation and natural history of the PIK3CA-related overgrowth spectrum. Am J Med Genet A 164:1713–1733
Kim JY, Jung SA, Sung MS et al (2004) Extra-articular soft tissue ganglion cyst around the knee: focus on the associated findings. Eur Radiol 14:106–111
Kontogeorgakos VA, Martinez S, Dodd L, Brigman BE (2010) Extremity soft tissue sarcoma presented as hematomas. Arch Orthop Trauma Surg 130:1209–1214
Kransdorf MJ (1995) Benign soft-tissue tumors in a large referral population: distribution of specific diagnoses by age, sex, and location. AJR Am J Roentgenol 164:395–402
Kransdorf MJ, Murphey MD (2006) Vascular and lymphatic tumors. In: Imaging of soft tissue tumors, 2nd edn. Lippincott, Williams & Wilkins, Philadelphia
Lee JC, Thomas JM, Phillips S et al (2006) Aggressive fibromatosis: MRI features with pathologic correlation. AJR Am J Roentgenol 186:247–254
Lewis RJ, Ketcham AS (1973) Maffucci’s syndrome: functional and neoplastic significance—case report and review of the literature. J Bone Joint Surg Am 55:1465–1479
Malghem J, Vande Berg BC, Lebon C et al (1998) Ganglion cysts of the knee: articular communication revealed by delayed radiography and CT after arthrography. AJR Am J Roentgenol 170:1579–1583
May DA, Disler DG, Jones EA et al (2000) Abnormal signal intensity in skeletal muscle at MR imaging: patterns, pearls, and pitfalls. Radiographics 20:S295–S315
McGuinness B, Wilson N, Doyle AJ (2007) The “penumbra sign” on T1-weighted MRI for differentiating musculoskeletal infection from tumor. Skeletal Radiol 36:417–421
Mellado JM, Bencardino JT (2005) Morel-Lavallée lesion: review with emphasis on MR imaging. Magn Reson Imaging Clin N Am 13:775–782
Murphey MD, McRae GA, Fanburg-Smith JC et al (2002) Imaging of soft tissue myxoma with emphasis on CT and MRI and comparison of radiologic and pathological findings. Radiology 225:215–224
Murphey MD, Rhee JH, Lewis RB et al (2008) Pigmented villonodular synovitis: radiologic-pathologic correlation. Radiographics 28:1493–1518
Naylor MF, Nascimento AG, Sherrick AD, McLeod RA (1996) Elastofibroma dorsi: radiologic findings in 12 patients. AJR Am J Roentgenol 167:683–687
Olsen KM, Chew FS (2006) Tumoral calcinosis: pearls, polemics, and alternative possibilities. Radiographics 26:871–885
Onishi Y, Kitajima K, Senda M et al (2011) FDG PET/CT imaging of elastofibroma dorsi. Skeletal Radiol 40:849–853
Otero S, Moskovic EC, Strauss DC et al (2015) Desmoid-type fibromatosis. Clin Radiol 70:1038–1045
Ozpolat B, Yazkan R, Yilmazer D et al (2008) Elastofibroma dorsi: report of a case with diagnostic features. J Ultrasound Med 27:287–291
Park JS, Ryu KN (2004) Hemophilic pseudotumor involving the musculoskeletal system: spectrum of radiologic findings. AJR Am J Roentgenol 183:55–61
Pasternak S, Wright BA, Walsh N (2007) Soft tissue amyloidoma of the extremities: report of a case and review of the literature. Am J Dermatopathol 29:152–155
Patel A, Davies AM, James SL (2015) Imaging of extremity soft tissue masses: pitfalls in diagnosis. Br J Hosp Med 76:344–352
Quinn SF, Erickson SJ, Dee PM et al (1991) MR imaging in fibromatosis: results in 26 patients with pathologic correlation. AJR Am J Roentgenol 156:539–542
Schaffer PR, Hale CS, Meehan SA, Shupack JL, Ramachandran S (2014) Adiposis dolorosa. Dermatol Online J 20(12) pii: 13030/qt1st6x3dm
Siegel MJ (2001) Magnetic resonance imaging of musculoskeletal soft tissue masses. Radiol Clin N Am 39:701–720
Sookur PA, Naraghi AM, Bleakney RR et al (2008) Accessory muscles: anatomy, symptoms, and radiologic evaluation. Radiographics 28:481–499
Sreenivas M, Nihal A, Ettles DF (2004) Chronic hematoma or soft-tissue neoplasm? A diagnostic dilemma. Arch Orthop Trauma Surg 124:495–497
Stabler J (1995) Case report: ossifying metastases from carcinoma of the large bowel demonstrated by bone scintigraphy. Clin Radiol 50:730–731
Sung MS, Kang HS, Suh JS et al (2000) Myxoid liposarcoma: appearance at MR imaging with histologic correlation. Radiographics 20:1007–1019
Teo HEL, Peh WCG, Shek TWH (2005) Case 84: desmoid tumor of the abdominal wall. Radiology 236:81–84
Tins BJ, Matthews C, Haddaway M et al (2013) Adiposis dolorosa (Dercum’s disease): MRI and ultrasound appearances. Clin Radiol 68:1047–1053
Tyler P, Saifuddin A (2010) The imaging of myositis ossificans. Semin Musculoskelet Radiol 14:201–216
Ulaner G, Hwang S, Landa J et al (2013a) Musculoskeletal tumors and tumor-like conditions: common and avoidable pitfalls at imaging in patients with known or suspected cancer. Int Orthop 37:871–876
Ulaner G, Hwang S, Landa J et al (2013b) Musculoskeletal tumors and tumor-like conditions: common and avoidable pitfalls at imaging in patients with known or suspected cancer. Part B: malignant mimics of benign tumors. Int Orthop 37:877–882
Vilanova JC, Barcelo J, Smirniotopoulos JG et al (2004) Hemangioma from head to toe: MR imaging with pathologic correlation. Radiographics 24:367–385
Wu JS, Hochman MG (2009) Soft-tissue tumors and tumorlike lesions: a systematic imaging approach. Radiology 253:297–316
Yu JS, Chung C, Recht M et al (1997) MR imaging of tophaceous gout. AJR Am J Roentgenol 168:523–527
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Whitehouse, R.W., Kirwadi, A. (2017). Musculoskeletal Soft Tissue Tumors: CT and MRI Pitfalls. In: Peh, W. (eds) Pitfalls in Musculoskeletal Radiology. Springer, Cham. https://doi.org/10.1007/978-3-319-53496-1_28
Download citation
DOI: https://doi.org/10.1007/978-3-319-53496-1_28
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-53494-7
Online ISBN: 978-3-319-53496-1
eBook Packages: MedicineMedicine (R0)