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MR appearance of clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts): radiologic-pathologic correlation

Abstract

Clear cell sarcoma of tendons and aponeuroses (CCSTA) is a rare aggressive soft tissue tumor that frequently produces melanin. Its MR findings are rarely described in the literature. We report the case of a previously healthy 54-year-old man with clear cell sarcoma of the thigh who presented with a large painless mass of 1 year’s duration. MR imaging showed the tumor to be of high signal intensity on fast spin-echo and STIR images. Both fine needle aspiration and excisional biopsy showed abundant melanin pigments. Histologic diagnosis was compatible with CCSTA.

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References

  1. Enzinger FM. Clear cell sarcoma of tendons and aponeuroses: an analysis of 21 cases. Cancer 1965; 18:1163–1174.

    CAS  PubMed  Google Scholar 

  2. Chung EM, Enzinger FM. Malignant melanoma of soft parts. A reassessment of clear cell sarcoma. Am J Surg Pathol 1983; 7:405–415.

    Google Scholar 

  3. Fletcher CDM, Unni KK, Mertens F, eds. World Health Organization classification of tumors. Pathology and genetics. Tumours of soft tissue and bone. Lyon: IARC Press, 2002:211–212.

  4. Kindblom LG, Lodding P, Angervall L. Clear-cell sarcoma of tendons and aponeuroses. An immunohistochemical and electron microscopic analysis indicating neural crest origin. Virchows Arch [A] Pathol Anat Histopathol 1983; 401:109–128.

    Google Scholar 

  5. Langezaal SM, Graadt van Roggen JF, Cleton-Jansen AM, Baelde JJ, Hogendoorn PCW. Malignant melanoma is genetically distinct from clear cell sarcoma of tendons and aponeurosis (malignant melanoma of soft parts). Br J Cancer 2001; 84:535–538.

    Article  CAS  PubMed  Google Scholar 

  6. Segal NH, Pavlidis P, Noble WS, et al. Classification of clear-cell sarcoma as a subtype of melanoma by genomic profiling. J Clin Oncol 2003; 21:1775–1781.

    Google Scholar 

  7. Lucas DR, Nascimento AG, Sim FH. Clear cell sarcoma of soft tissues. Mayo Clinic experience with 35 cases. Am J Surg Pathol 1992; 16:1197–1204.

    Google Scholar 

  8. Tong TR, Chow T-C, Chan OW-H, Lee K-C, Yeung S-H, Lam A, Yu C-K. Clear-cell sarcoma diagnosis by fine-needle aspiration: cytologic, histologic, and ultra-structural features; potential pitfalls; and literature review. Diagn Cytopathol 2002; 26:174–180.

    Google Scholar 

  9. Shabb NS, Boulos F, Tawil A, Hussein M, Hourani M. Clear cell sarcoma (malignant melanoma of soft parts): fine-needle aspiration cytology of a highly pigmented tumor. Diagn Cytopathol 2003; 28:313–315.

    Google Scholar 

  10. Iwamoto Y, Morimoto N, Chuman H, Shinohara N, Sugioka Y. The role of MR imaging in the diagnosis of alveolar soft part sarcoma: a report of 10 cases. Skeletal Radiol 1995; 24:267–270.

    Google Scholar 

  11. Enochs WS, Petherick P, Bogdanova A, Mohr U, Weissleder R. Paramagnetic metal scavenging by melanin: MR imaging. Radiology 1997; 204:417–423.

    Google Scholar 

  12. Isoa H, Kuroda M, Saitoh M, Asakura T, Akai M, Ikeda K, Jin E, Sawada S. MR findings of clear cell sarcoma: two case reports. Clin Imaging 2003; 27:229–232.

    Google Scholar 

  13. De Beuckeleer LH, De Schepper AM, Vandevenne JE, et al. 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 2000; 29:187–195.

    Article  PubMed  Google Scholar 

  14. Wetzel LH, Levine E. Soft-tissue tumors of the foot: value of MR imaging for specific diagnosis. AJR Am J Roentgenol 1990; 155:1025–1030.

    Google Scholar 

  15. Schnarkowski P, Peterfy CG, Johnston JO, Weidner N. Clear cell sarcoma mimicking peripheral nerve sheath tumor. Skeletal Radiol 1996; 25:197–200.

    Google Scholar 

  16. Prieskorn DW, Irwin RB, Hankin R. Clear cell sarcoma presenting as an interdigital neuroma. Orthop Rev 1992; 21:963–970.

    Google Scholar 

  17. Gandolfo N, Martinoli C, Cafiero F, et al. Malignant melanoma of soft tissues (clear cell sarcoma) of the foot. Is MRI able to perform a specific diagnosis? Report of one case and review of the radiological literature. Anticancer Res 2000; 20:3993–3998.

    Google Scholar 

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Correspondence to Mukbil Hourani.

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Hourani, M., Khoury, N., Mourany, B. et al. MR appearance of clear cell sarcoma of tendons and aponeuroses (malignant melanoma of soft parts): radiologic-pathologic correlation. Skeletal Radiol 34, 543–546 (2005). https://doi.org/10.1007/s00256-005-0893-z

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  • DOI: https://doi.org/10.1007/s00256-005-0893-z

Keywords

  • Thigh
  • Malignant melanoma
  • Clear cell sarcoma
  • Magnetic resonance imaging