Computed tomography imaging features of malignant ‘triton’ tumor to facilitate its clinical diagnosis: report of two cases

Abstract

Background Malignant ‘triton’ tumor is an extremely rare subtype of malignant periphery nerve sheath tumors. Clinical diagnosis of malignant triton tumor is difficult before surgery due to its low incidence and the lack of knowledge. Therefore, to describe and summarize the CT imaging characteristics of malignant triton tumor is of great assistance for early and preoperative diagnosis. Case presentation Two cases suspected of MTT by CT scan before operation were closely observed. The diagnosis of malignant triton tumor was eventually confirmed by immunochemical assay, which verified speculation of CT scans. Huge, irregular, well-circumscribed lobulated mass-like shadows can be observed from these patients by CT scans. Besides, heterogeneity of density within the body of tumor was well-established by CT scans, together with linear septum. Meanwhile, CT scans demonstrated that calcifications were remarkable at the margin of tumor body. Conclusions Some CT image features from two cases were presented as a reference for the preoperative consideration of MTT: (i) enormity of mass-like shadow; (ii) presence of well-circumscribed lobulated shape; (iii) septum within the well-defined mass accompanied with hemorrhage, necrosis and cystic changes as well as calcification, especially within neurofibromatosis type 1 patients.

Malignant triton tumor of uterus: A case report and literature review

“…We compiled data on reported cases of MTT in the recent 6 years (2018–2023, Table 1). 1,6–38 There were totally 37 cases with a mean age of 39.4 years (range 8 months old–75 years old), including 24 male and 13 female patients. Eleven cases originated in the abdomen (30%), 10 cases in the head and neck (27%), 8 cases in the thoracic cavity (21%), 6 cases in the limbs (16%), 1 case in the spine (3%), and 1 case in the buttocks (3%).…”

“…A range of cases presentation in the literature we reviewed describe the imaging manifestations (including CT and MRI) correlated with MTT: giant lump, heterogeneity, irregular margins, intratumoral hemorrhage, necrosis, lobulation, calcifications, heterogenous enhancement on postcontrast CT or MRI, hypointense/isointense T1WI and hyperintense T2WI signal on MRI, and diffusion restriction on DWI and ADC 1,8–32,39,40 . Zain et al 20 and Li et al 29 had reported similar conclusions, Li et al pointed out some characteristics common to MTTs and MPNSTs, including ill‐defined margin, intratumoral lobulation, peripheral edema, calcifications, and destruction of adjacent bone tissues. In our case, it manifested as a heterogeneous giant mass with unclear border in ultrasonography, long T1 and T2 signals on MRI, marginal lobulation, and multiple metastases on PET‐CT.…”

Primary hepatic malignant triton tumor mimicking hepatocellular carcinoma by demonstrating arterial-phase hypervascularity and subsequent washout on dynamic contrast-enhanced imaging: a case report and literature review

“…Clinical or radiological suspicion is very difficult due to the scarcity of these tumors. Based on CT analysis, Li Y et al summarized the reference clinical characteristics for the diagnosis of MTT: (i) an enormous mass-like shadow; (ii) a well-circumscribed lobulated shape; and (iii) a well-defined mass with hemorrhages, necrosis, cystic changes and calcification, especially within NF-1 patients ( 21 ). In our case, the MTT mimicked hepatocellular carcinoma on MRI and CT, where an enhancement pattern was observed as fast-in and fast-out.…”