Abstract
Background
Because of the distinctive clinical and MR findings associated with benign peripheral neurogenic tumors (BPNTs), they are commonly diagnosed without histological confirmation. As such, they are one of the most frequently misdiagnosed entities among the soft tissue sarcomas (STSs) that undergo initial unplanned excision. In this study, we investigate the characteristics of STSs misdiagnosed as BPNTs.
Methods
We present a series of nine STS patients with an initial preoperative diagnosis of BPNT (BPNT-STS), and compare their clinical and MR findings to those of the 18 genuine BPNT patients, matched for site, depth, and size of tumors as well as related nerves.
Results
Among the nine BPNT-STS cases, the most common histological diagnosis was synovial sarcoma (n = 4). Six patients (67 %) had deep-seated tumors; four patients (44 %) had tumors 5 cm or greater in size. BPNT-STS patients were more likely to experience pain (78 % vs. 22 %) and shorter symptom duration (9 vs. 55 months) compared to BPNT patients. A target sign on MR imaging was observed only in BPNT patients (0 % vs. 50 %), whereas peritumoral edema was found only in BPNT-STS patients (33 % vs. 0 %).
Conclusions
If a tumor suggestive of a BPNT is painful, with a relatively short symptom duration, and presents with peritumoral edema without a definite target sign on MR images, the possibility of an STS must be considered.
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Acknowledgments
The authors wish to thank Sang A Lee for her assistance with the collection of data.
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The authors each declare that they have no conflict of interest.
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Kang, S., Yoo, H.J., Kim, HS. et al. Soft tissue sarcoma misdiagnosed as benign peripheral neurogenic tumor. J Orthop Sci 20, 180–185 (2015). https://doi.org/10.1007/s00776-014-0662-8
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DOI: https://doi.org/10.1007/s00776-014-0662-8