No abstract

Magnetic resonance (MR) imaging reveals a broad range of musculoskeletal abnormalities in patients with sarcoidosis, including focal and diffuse muscle lesions, soft-tissue masses, joint abnormalities, and marrow infiltration of small and large bones. Long bone and axial skeletal involvement may be occult at conventional radiography but depicted at MR imaging, with an appearance that resembles that of osseous metastases. Sarcoidosis-related findings may be detected at dedicated MR imaging for osteoarticular symptoms in sarcoidosis patients or encountered incidentally at MR imaging performed for other indications. Correlation with clinical and laboratory findings is essential for correct diagnosis because the MR imaging findings are nonspecific in most cases. The radiologist should be aware of potential sarcoidal causes in the differential diagnosis of musculoskeletal lesions in patients with proved or suspected sarcoidosis. Such consideration will have a profound effect on the interpretation of images and on the study of patients with dual diagnoses of sarcoidosis and neoplasm.

Laryngeal chondrosarcomas are uncommon, and those that contain a distinct, nonchondroid, high-grade spindle cell sarcoma (the so-called "dedifferentiated" chondrosarcoma or chondrosarcoma with additional malignant mesenchymal component [CAMMC]) are extremely rare. Laryngeal CAMMC merit special attention, as CAMMC in other sites portends a poor prognosis. Eleven patients with laryngeal chondrosarcomas are reported on; 2 of these patients had CAMMC. On follow-up, 3 of the 11 patients had recurrences. The first had recurrence 4 and 11 years after tumor enucleation; that patient died disease free 2 years after salvage total laryngectomy. The second had recurrence 2 years after partial laryngectomy and was lost to follow-up after salvage total laryngectomy. The last patient recurred 13 years after partial laryngectomy and underwent salvage total laryngectomy; that patient was one of the two who developed CAMMC, and he also developed stomal recurrence of the "dedifferentiated" component 3 years after total laryngectomy. The other 8 patients are disease free after partial laryngectomy (6) or total laryngectomy (2) 10 months to 12 years later (mean: 51 months). This includes the 1 other patient with CAMMC, who is disease free 60 months after total laryngectomy. Laryngeal CAMMC has been shown, in at least one of the two patients, to be associated with a poor outcome. Patients with recurrent laryngeal chondrosarcomas do not have a poorer outcome after salvage total laryngectomy. The authors advocate partial laryngectomy if technically feasible.