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Clinical features of soft tissue sarcoma presenting intra-tumour haematoma: case series and review of the literature

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Abstract

Introduction

Intra-tumour haematoma is an uncommon clinical presentation in malignant soft tissue tumours. This study aimed to highlight the clinical features of patients with soft tissue sarcomas with intra-tumour haematoma.

Methods

The patient group was composed of eight men and one woman aged between 29 and 83 years (mean 44.0 ± 20.8). The average follow-up was 29.8 months. Clinical information, including clinical features, radiological information and treatment course, was retrospectively investigated.

Results

Tumours were predominantly located in the chest wall and thigh, and average diameter was 10.3 cm. Six patients underwent needle biopsy with ultrasound sonography, and three underwent an open biopsy. Histological diagnoses indicated that all tumours were high grade, three of which were undifferentiated pleomorphic sarcomas, three synovial sarcomas, two pleomorphic liposarcomas, one a leiomyosarcoma and one a malignant peripheral nerve sheath tumour. The median diagnostic delay time was 3.0 months. Magnetic resonance imaging (MRI) indicated a haematoma area <25 % in three, 25–50 % in four and 50 % two. A wide resection was performed in eight patients, and radiotherapy was administered to one patient for the initial local treatment of a primary tumour. Local recurrence was detected in four patients, whilst five developed lung metastases. The five-year survival rate was 57.1 % and median survival 34.0 months.

Conclusions

Soft tissue sarcomas with intra-tumour haematoma presented with locally aggressive and highly metastatic behavior, consistent with high-grade tumours.

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References

  1. Imaizumi S, Morita T, Ogose A, Hotta T, Kobayashi H, Ito T, Hirata Y (2002) Soft tissue sarcoma mimicking chronic hematoma: value of magnetic resonance imaging in differential diagnosis. J Orthop Sci 7:33–37

    Article  PubMed  Google Scholar 

  2. Kontogeorgakos VA, Martinez S, Dodd L, Brigman BE (2010) Extremity soft tissue sarcomas presented as hematomas. Arch Orthop Trauma Surg 130:1209–1214

    Article  PubMed  Google Scholar 

  3. Ogose A, Hotta T, Yamamura S, Shioya Y, Yazawa T (1998) Extraskeletal Ewing’s sarcoma mimicking traumatic hematoma. Arch Orthop Trauma Surg 118:172–173

    Article  CAS  PubMed  Google Scholar 

  4. Flecher CDM, Bridge JA, Hogendoorn PCW et al (2002) WHO Classification of Tumors of Soft Tissue and Bone, 4th edn. IARC Press, Lyon

  5. Trojani M, Contesso G, Coindre JM et al (1984) Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer 33:37–42

    Article  CAS  PubMed  Google Scholar 

  6. Edge SB, Byrd DR, Compton CC et al (2010) AJCC Cancer Staging Manual, 7th edn. Springer, New York, pp 291–296, Soft tissue sarcoma

    Google Scholar 

  7. Van Dyck P, Vanhoenacker FM, Vogel J, Venstermans C, Kroon HM, Gielen J, Parizel PM, Bloem JL, De Schepper AM (2006) Prevalence, extension and characteristics of fluid-fluid levels in bone and soft tissue tumors. Eur Radiol 16:2644–2651

    Article  PubMed  Google Scholar 

  8. Ward WG Sr, Rougraff B, Quinn R, Damron T, O’Connor MI, Turcotte RE, Cline M (2007) Tumors masquerading as hematomas. Clin Orthop Relat Res 465:232–240

    PubMed  Google Scholar 

  9. Sternheim A, Jin X, Shmookler B, Jelinek J, Malawer MM (2008) ‘Telangiectatic’ transformation in soft tissue sarcomas. a clinicopathology analysis of an aggressive feature of high-grade sarcomas. Ann Surg Oncol 15:345–354

    Article  PubMed  Google Scholar 

  10. Gomez P, Morcuende J (2004) High-grade sarcomas mimicking traumatic intramuscular hematomas: a report of three cases. Iowa Orthop J 24:106–110

    PubMed  PubMed Central  Google Scholar 

  11. Niimi R, Matsumine A, Kusuzaki K, Okamura A, Matsubara T, Uchida A, Fukutome K (2006) Soft-tissue sarcoma mimicking large haematoma: a report of two cases and review of the literature. J Orthop Surg (Hong Kong) 14:90–95

    Article  CAS  Google Scholar 

  12. Sarkar K, Buckley C, Uhthoff HK (1986) Liposarcoma simulating a Baker’s cyst: a case study. Arch Orthop Trauma Surg 105:316–319

    Article  CAS  PubMed  Google Scholar 

  13. Naito N, Ozaki T, Kunisada T, Kawai A, Dan’ura T, Morimoto Y, Inoue H (2000) Synovial sarcoma with a large hematoma in the inguinal region. Arch Orthop Trauma Surg 120:533–534

    Article  CAS  PubMed  Google Scholar 

  14. Kelm J, Ahlhelm F, Engel C, Duchow J (2001) Synovial sarcoma diagnosed after a sports injury. Am J Sports Med 29:367–369

    CAS  PubMed  Google Scholar 

  15. Mann HA, Hilton A, Goddard NJ, Smith MA, Holloway B, Lee CA (2006) Synovial sarcoma mimicking haemophilic pseudotumour. Sarcoma 27212

  16. Lee KH, Joo JK, Kim DY, Lee JS, Choi C, Lee JH (2007) Mesenteric extraskeletal osteosarcoma with telangiectatic features: a case report. BMC Cancer 15:7–82

    Google Scholar 

  17. Gupta MM, Bahri N, Watal P, Rathod K, Thaker S, Bhandari P, Dhamecha K, Ajudia J (2015) Retroperitoneal cystic malignant fibrous histiocytoma mimicking a psoas abscess. Iran J Radiol 22:e17507

    Google Scholar 

  18. Jamshidi K, Yahyazadeh H, Bagherifard A (2015) Unusual presentation of synovial sarcoma as meniscal cyst: a case report. Arch Bone Jt Surg 3:296–299

    PubMed  PubMed Central  Google Scholar 

  19. Weiss SW, Enzinger FM (1978) Malignant fibrous histiocytoma: an analysis of 200 cases. Cancer 41:2250–2266

    Article  CAS  PubMed  Google Scholar 

  20. Jones BC, Sundaram M, Kransdorf MJ (1993) Synovial sarcoma: MR imaging findings in 34 patients. AJR Am J Roentgenol 161:827–830

    Article  CAS  PubMed  Google Scholar 

  21. Nakanishi H, Araki N, Sawai Y, Kudawara I, Mano M, Ishiguro S, Ueda T, Yoshikawa H (2003) Cystic synovial sarcomas: imaging features with clinical and histopathologic correlation. Skeletal Radiol 32:701–707

    Article  PubMed  Google Scholar 

  22. Morton MJ, Berquist TH, McLeod RA, Unni KK, Sim FH (1991) MR imaging of synovial sarcoma. AJR Am J Roentgenol 156:337–340

    Article  CAS  PubMed  Google Scholar 

  23. Taïeb S, Penel N, Vanseymortier L, Ceugnart L (2009) Soft tissue sarcomas or intramuscular haematomas? Eur J Radiol 72:44–49

    Article  PubMed  Google Scholar 

  24. Rumberger LK, Lewis J (2015) Chronic expanding hematoma of the thigh masquerading as a soft tissue malignancy. Am Surg 81:279–281

    Google Scholar 

  25. Bogumill GP, Bruno PD, Barrick EF (1981) Malignant lesions masquerading as popliteal cysts. A report of three cases. J Bone Joint Surg Am 63:474–477

    Article  CAS  PubMed  Google Scholar 

  26. Oebisu N, Hoshi M, Ieguchi M, Takada J, Iwai T, Ohsawa M, Nakamura H (2014) Contrast-enhanced color Doppler ultrasonography increases diagnostic accuracy for soft tissue tumors. Oncol Rep 32:1654–1660

    PubMed  Google Scholar 

  27. Kawaguchi N, Ahmed AR, Matsumoto S, Manabe J, Matsushita Y (2004) The concept of curative margin in surgery for bone and soft tissue sarcoma. Clin Orthop 419:165–172

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-Machi, Abeno-ku, Osaka, 545-8585, Japan

    Manabu Hoshi, Naoto Oebisu, Makoto Ieguchi, Yoshitaka Ban, Masatsugu Takami & Hiroaki Nakamura

Authors
  1. Manabu Hoshi
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  2. Naoto Oebisu
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  3. Makoto Ieguchi
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  4. Yoshitaka Ban
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  5. Masatsugu Takami
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  6. Hiroaki Nakamura
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Correspondence to Manabu Hoshi.

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The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

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The Institutional Ethics Review Board approved the study protocol.

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Hoshi, M., Oebisu, N., Ieguchi, M. et al. Clinical features of soft tissue sarcoma presenting intra-tumour haematoma: case series and review of the literature. International Orthopaedics (SICOT) 41, 203–209 (2017). https://doi.org/10.1007/s00264-016-3322-0

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  • DOI: https://doi.org/10.1007/s00264-016-3322-0

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