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Myxoinflammatory fibroblastic sarcoma: spectrum of disease and imaging presentation

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Abstract

Objectives

To describe the imaging findings of a series of myxoinflammatory fibroblastic sarcomas (MFSs) from our institution, including a case of dedifferentiated MFS and two cases with areas of high-grade tumor, in addition to typical cases of low-grade tumor. To correlate the imaging findings with the pathologic features of these tumors.

Subjects and methods

IRB approval was obtained. Retrospective search of the pathology database at our institution from 2000 to 2015 identified seven cases of MFS with available imaging. Imaging, pathology, and clinical data were reviewed.

Results

Unlike the majority of well-differentiated tumors in our series (four cases), one tumor showed dedifferentiation and two cases had areas of high-grade tumor. The dedifferentiated tumor showed peripheral post-contrast enhancement. One case with a substantial high-grade component showed osseous destruction and peripheral enhancement in the high-grade area, while the low-grade component enhanced diffusely. The second case had a small high-grade area and showed diffuse enhancement. All three of these cases had non-acral locations and lacked association with a tendon. The four cases of low-grade MFS demonstrated diffuse enhancement, were located in the distal extremities, and were associated with a tendon.

Conclusion

The imaging findings of dedifferentiated and high-grade MFS differ from the more typical low-grade tumors in that they have nonenhancing areas, a non-acral location, lack association with a tendon, and may involve bone. The radiologist should be aware that MFS represents a spectrum that includes low-grade tumors, tumors with high-grade areas, and tumors with dedifferentiation and that this spectrum presents with differing imaging features.

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Authors and Affiliations

  1. Department of Radiology, University of Michigan Health System, 1500 E Medical Center Drive, TC 2852B, Ann Arbor, MI, 48109, USA

    Kara Gaetke-Udager, Corrie M. Yablon & Yoav Morag

  2. Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA

    David R. Lucas

Authors
  1. Kara Gaetke-Udager
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  2. Corrie M. Yablon
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  3. David R. Lucas
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  4. Yoav Morag
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Correspondence to Kara Gaetke-Udager.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in 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. This article does not contain any studies with animals performed by any of the authors.

Informed consent

IRB exemption was obtained from our institution. All patient data were obtained using retrospective review of the medical records. No live patient interaction occurred; therefore, informed consent was not required by our IRB and was not obtained.

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Gaetke-Udager, K., Yablon, C.M., Lucas, D.R. et al. Myxoinflammatory fibroblastic sarcoma: spectrum of disease and imaging presentation. Skeletal Radiol 45, 347–356 (2016). https://doi.org/10.1007/s00256-015-2286-2

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  • DOI: https://doi.org/10.1007/s00256-015-2286-2

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