Skip to main content
SpringerLink
Log in

MRI findings to differentiate musculoskeletal dedifferentiated liposarcoma from atypical lipomatous tumor

  • Musculoskeletal Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Objective

This study aimed to assess the efficacy of using MRI findings for differentiating musculoskeletal dedifferentiated liposarcoma (DDLP) from atypical lipomatous tumor (ALT).

Materials and methods

This study included 22 patients with histopathologically proven DDLP and 35 with ALT in the musculoskeletal areas. All DDLPs were immunohistochemically positive for MDM2. MRI findings for both pathologies were retrospectively reviewed and compared.

Results

The maximum lesion diameter was significantly lower in DDLPs than in ALTs (p < 0.01). Ill-defined margin, peritumoral edema, and tail sign were more frequently observed in DDLPs than in ALTs (p < 0.01, respectively). The fatty component was less frequently observed in DDLPs than in ALTs (27 vs. 100%; p < 0.01), whereas the non-fatty component was more frequently observed in DDLPs than in ALTs (100 vs. 11%; p < 0.01). The occupation rate by non-fatty components was significantly higher in DDLPs than in ALTs (p < 0.01). No significant differences were observed in imaging findings associated with fatty component; however, necrosis within the non-fatty component on the contrast-enhanced image was more frequently observed in DDLPs than in ALTs (72 vs. 0%, p < 0.05).

Conclusion

DDLPs always had a non-fatty component, whereas ALTs always had fatty component. Ill-defined margin, peritumoral edema, tail sign, and necrosis within non-fatty components were useful MRI features for differentiating musculoskeletal DDLP from ALT.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Sbaraglia M, Dei Tos A, Pedeutour F (2020) Atypical lipomatous tumour/well-differentiated liposarcoma. WHO classification of Soft Tissue and Bone Tumours, 5th ed Lyon, France: IARC Press. pp 36–38

  2. Dei Tos A, Marino-Enriquez A, Pedeutour F (2020) Dedifferentiated liposarcoma. WHO classification of Soft Tissue and Bone Tumours, 5th ed Lyon, France: IARC Press. pp 39–41

  3. Thway K (2019) Well-differentiated liposarcoma and dedifferentiated liposarcoma: an updated review. Semin Diagn Pathol 36(2):112–121. https://doi.org/10.1053/j.semdp.2019.02.006

    Article  Google Scholar 

  4. Vos M, Boeve WC, van Ginhoven TM, Sleijfer S, Verhoef C, Grünhagen DJ (2019) Impact of primary tumor location on outcome of liposarcoma patients, a retrospective cohort study. Eur J Surg Oncol 45(12):2437–2442. https://doi.org/10.1016/j.ejso.2019.08.026

    Article  CAS  Google Scholar 

  5. Vos M, Koseła-Paterczyk H, Rutkowski P, van Leenders G, Normantowicz M, Lecyk A, Sleijfer S, Verhoef C, Grünhagen DJ (2018) Differences in recurrence and survival of extremity liposarcoma subtypes. Eur J Surg Oncol 44(9):1391–1397. https://doi.org/10.1016/j.ejso.2018.03.028

    Article  CAS  Google Scholar 

  6. Asano Y, Miwa S, Yamamoto N, Hayashi K, Takeuchi A, Igarashi K, Yonezawa H, Araki Y, Morinaga S, Nojima T, Ikeda H, Tsuchiya H (2022) A scoring system combining clinical, radiological, and histopathological examinations for differential diagnosis between lipoma and atypical lipomatous tumor/well-differentiated liposarcoma. Sci Rep 12(1):237. https://doi.org/10.1038/s41598-021-04004-1

    Article  CAS  Google Scholar 

  7. Nardo L, Abdelhafez YG, Acquafredda F, Schirò S, Wong AL, Sarohia D, Maroldi R, Darrow MA, Guindani M, Lee S, Zhang M, Moawad AW, Elsayes KM, Badawi RD, Link TM (2020) Qualitative evaluation of MRI features of lipoma and atypical lipomatous tumor: results from a multicenter study. Skeletal Radiol 49(6):1005–1014. https://doi.org/10.1007/s00256-020-03372-5

    Article  Google Scholar 

  8. Brisson M, Kashima T, Delaney D, Tirabosco R, Clarke A, Cro S, Flanagan AM, O’Donnell P (2013) MRI characteristics of lipoma and atypical lipomatous tumor/well-differentiated liposarcoma: retrospective comparison with histology and MDM2 gene amplification. Skeletal Radiol 42(5):635–647. https://doi.org/10.1007/s00256-012-1517-z

    Article  Google Scholar 

  9. Shim EJ, Yoon MA, Yoo HJ, Chee CG, Lee MH, Lee SH, Chung HW, Shin MJ (2020) An MRI-based decision tree to distinguish lipomas and lipoma variants from well-differentiated liposarcoma of the extremity and superficial trunk: classification and regression tree (CART) analysis. Eur J Radiol 127:109012. https://doi.org/10.1016/j.ejrad.2020.109012

    Article  Google Scholar 

  10. Pressney I, Khoo M, Endozo R, Ganeshan B, O’Donnell P (2020) Pilot study to differentiate lipoma from atypical lipomatous tumour/well-differentiated liposarcoma using MR radiomics-based texture analysis. Skeletal Radiol 49(11):1719–1729. https://doi.org/10.1007/s00256-020-03454-4

    Article  Google Scholar 

  11. Bhosale P, Wang J, Varma D, Jensen C, Patnana M, Wei W, Chauhan A, Feig B, Patel S, Somaiah N, Sagebiel T (2016) Can Abdominal computed tomography imaging help accurately identify a dedifferentiated component in a well-differentiated liposarcoma? J Comput Assist Tomogr 40(6):872–879. https://doi.org/10.1097/rct.0000000000000462

    Article  Google Scholar 

  12. Yun JS, Chung HW, Song JS, Lee SH, Lee MH, Shin MJ (2019) Dedifferentiated liposarcoma of the musculoskeletal system: expanded MR imaging spectrum from predominant fatty mass to non-fatty mass. Acta Radiol 60(11):1474–1481. https://doi.org/10.1177/0284185119833060

    Article  Google Scholar 

  13. Kanda Y (2013) Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transp 48(3):452–458. https://doi.org/10.1038/bmt.2012.244

    Article  CAS  Google Scholar 

  14. Okada K, Hasegawa T, Kawai A, Ogose A, Nishida J, Yanagisawa M, Morita T, Tajino T, Tsuchiya T (2011) Primary (de novo) dedifferentiated liposarcoma in the extremities: a multi-institution tohoku musculoskeletal tumor society study of 18 cases in northern Japan. Jpn J Clin Oncol 41(9):1094–1100. https://doi.org/10.1093/jjco/hyr098

    Article  Google Scholar 

  15. Crombé A, Marcellin PJ, Buy X, Stoeckle E, Brouste V, Italiano A, Le Loarer F, Kind M (2019) Soft-tissue sarcomas: assessment of MRI features correlating with histologic grade and patient outcome. Radiology 291(3):710–721. https://doi.org/10.1148/radiol.2019181659

    Article  Google Scholar 

  16. Yoo HJ, Hong SH, Kang Y, Choi JY, Moon KC, Kim HS, Han I, Yi M, Kang HS (2014) MR imaging of myxofibrosarcoma and undifferentiated sarcoma with emphasis on tail sign; diagnostic and prognostic value. Eur Radiol 24(8):1749–1757. https://doi.org/10.1007/s00330-014-3181-2

    Article  Google Scholar 

  17. Morii T, Tajima T, Honya K, Aoyagi T, Ichimura S (2018) Clinical significance of the tail-like pattern in soft-tissue sarcomas on magnetic resonance imaging. J Orthop Sci 23(6):1032–1037. https://doi.org/10.1016/j.jos.2018.06.010

    Article  Google Scholar 

  18. Sciot R (2021) MDM2 amplified sarcomas: a literature review. Diagnostics 11(3):496. https://doi.org/10.3390/diagnostics11030496

    Article  CAS  Google Scholar 

  19. Le Guellec S, Chibon F, Ouali M, Perot G, Decouvelaere AV, Robin YM, Larousserie F, Terrier P, Coindre JM, Neuville A (2014) Are peripheral purely undifferentiated pleomorphic sarcomas with MDM2 amplification dedifferentiated liposarcomas? Am J Surg Pathol 38(3):293–304. https://doi.org/10.1097/pas.0000000000000131

    Article  Google Scholar 

Download references

Funding

No funding was received for this study.

Author information

Authors and Affiliations

  1. Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan

    Masaya Kawaguchi, Hiroki Kato, Yoshifumi Noda & Masayuki Matsuo

  2. Department of Pathology, Gifu University, Gifu, Japan

    Kazuhiro Kobayashi & Tatsuhiko Miyazaki

  3. Department of Orthopedic Surgery, Gifu University, Gifu, Japan

    Akihito Nagano

  4. Department of Radiology, Frontier Science for Imaging, Gifu University, Gifu, Japan

    Fuminori Hyodo

Authors
  1. Masaya Kawaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hiroki Kato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kazuhiro Kobayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tatsuhiko Miyazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Akihito Nagano
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yoshifumi Noda
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fuminori Hyodo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Masayuki Matsuo
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

MK, HK, and KK were guarantors of integrity of the entire study. MK, HK, KK, and TM contributed to study concepts and design. MK, HK, and TM were involved in literature research. AN, KK, and TM contributed to clinical studies. HK and TM were involved in experimental studies/data analysis. MK and HK contributed to statistical analysis. MK, HK, YN, and FH were involved in manuscript preparation. HK, YN, FH, and MM contributed to manuscript editing.

Corresponding author

Correspondence to Masaya Kawaguchi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

The requirement for informed consent was waived due to the retrospective nature of this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kawaguchi, M., Kato, H., Kobayashi, K. et al. MRI findings to differentiate musculoskeletal dedifferentiated liposarcoma from atypical lipomatous tumor. Radiol med 127, 1383–1389 (2022). https://doi.org/10.1007/s11547-022-01547-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-022-01547-9

Keywords

Search

Navigation