Features of ultrasound and contrast enhanced ultrasound in superficial desmoid-type fibromatosis: A series of 19 cases

Abstract

This study aimed to describe the characteristics of superficial desmoid fibromatosis (DF) using two-dimensional and contrast-enhanced ultrasonography, intending to improve diagnostic accuracy. We retrospectively analyzed 19 cases of superficial DF confirmed by surgery or core-needle biopsy in our hospital from January 2018 to August 2020. All patients underwent two-dimensional and contrast-enhanced ultrasound (CEUS) examination. Nineteen patients included 15 women and 4 men, with an average age of 33.37±12.13 years old. The mean size of lesions was 4.78±1.99 cm. On ultrasound, all lesions presented as solitary heterogeneous hypoechoic masses; 13 presented with ill-defined margins. Ten lesions (52.63%) presented with fusiform shapes, and 11 lesions (57.89%) presented with the “fascial tail” sign. CEUS suggested the tumors were hyperenhanced, with an enhanced pattern of rapid wash-in and slow wash-out. Four lesions (21.05%) showed an enlarged scope in the CEUS image compared with the grayscale ultrasound image. In conclusion, an ill-defined heterogeneous hyperechoic appearance with fusiform-shaped and “fascial tail” signs on US and heterogeneous hyperenhancement with an enlarged scope on CEUS are valuable clues in the diagnosis and treatment of superficial DF.

Investigations on ultrasonography in the diagnosis of nodular localized cutaneous neurofibroma

“…Fascial tail sign is characterized by the tumor extending along both sides within the fascial layer and is an important feature of tumors, such as desmoid fibromatosis, nodular fasciitis, and myxofibrosarcoma in both ultrasound and MRI imaging. [10][11][12] This sign appears similar to the "rat tail sign" in imaging, which could potentially lead to an increased risk of false positive diagnoses.…”

“…In this study, only 25.6% (11/43) of the lesions showed the “rat tail sign,” which is consistent with the study of Tsai et al 8 and Abreu et al 9 Therefore, the absence of the “rat tail sign” cannot exclude the diagnosis of NLCN. Meanwhile, fascial tail sign could be mistaken for “rat tail sign.” Fascial tail sign is characterized by the tumor extending along both sides within the fascial layer and is an important feature of tumors, such as desmoid fibromatosis, nodular fasciitis, and myxofibrosarcoma in both ultrasound and MRI imaging 10–12 . This sign appears similar to the “rat tail sign” in imaging, which could potentially lead to an increased risk of false positive diagnoses.…”

Dual-phase contrast-enhanced multislice computed tomography scans play a key role in the diagnosis of abdominal wall desmoid-type fibromatoses

“…However, there are few reports on the ultrasonic diagnosis of AWDF at present. Most of they were only get some preliminary diagnostic information by judging whether the mass was from muscle tissue, determining the cystic solid of the mass and measuring the size of the mass, which cannot make a good qualitative diagnosis [ 18 , 19 ]. Although ultrasonography is the first method used to evaluate a surface mass, it lacks specificity and has a high misdiagnosis rate.…”

Practical approach to ultrasound of soft tissue tumors and the added value of MRI: how I do it

“…CEUS may, however, be helpful in assessing tumor activity and treatment response. In a study of 19 patients with desmoid-type fibromatosis, variable tumor enhancement was seen, with the most Practical approach to ultrasound of soft tissue tumors and the added value of MRI: how I do it common pattern being hyperenhancement with rapid wash-in and slow washout, compared to surrounding muscle (28) . CEUS can also be helpful in identifying areas of viable tissue for targeted biopsy, especially in heterogeneous, possibly necrotic soft tissue tumors (29) .…”