Myositis ossificans mimicking sarcoma, the importance of diagnostic imaging – case report

Łuczyńska, Elżbieta; Kasperkiewicz, Hanna; Domalik, Agnieszka; Ćwierz, Anna; Bobek-Billewicz, Barbara

doi:10.12659/pjr.890209

Cited by 26 publications

(11 citation statements)

References 3 publications

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“…The radiologic findings of early MO depended on the site and extent of its evolution. According to past reports and our study, the typical MRI features of early MO are as follows: (1) the intramuscular lesion shows as isointense or slightly hyperintense in T1-WI and hyperintense in T2-WI [ 3 , 4 , 8 , 14 , 15 ], (2) the margin of the lesion may be ill-defined, with extensive surrounding muscle edema [ 3 , 4 , 16 ], and (3) the lesion appears diffusely or peripherally enhanced after MRI contrast enhancement [ 3 , 4 , 17 ]. Sometimes, periostitis, reactive joint effusions, and bone marrow edema may appear in acute conditions [ 3 ].…”

Section: Discussionmentioning

confidence: 65%

MRI Findings of Early Myositis Ossificans without Calcification or Ossification

Wang

Nie

et al. 2018

BioMed Research International

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Purpose To characterize and evaluate the MR imaging features of early myositis ossificans (MO) without calcification or ossification. Methods The MRI manifestations of seven patients with pathologically proven early MO were retrospectively analyzed with regard to tumor location, size, margins, signal intensity, and enhancement appearance in MR images. Additionally, the surrounding soft-tissue edema and adjacent bone change were assessed. Results All cases (n=7) had intramuscular tumor-like masses without calcifications. The lesions appeared as isointense in T1-weighted images (T1-WI) and inhomogeneous hyperintense in T2-weighted MR images (T2-WI). On T2-WI and postcontrast T1-WI, the heterogeneously high signal intensity in the expanded muscle interspersed with a few hypointense linear structures consistent with intact muscle fibers showed “striate pattern” in the plane parallel with muscle fibers. The relatively hypointense areas with geometrical pattern consistent with the bundles of intact muscle fibers are found within the lesion with diffuse high signal intensity, displaying the “checkerboard-like pattern” in the plane vertical to muscle fibers. A “striate pattern” (n = 7) and “checkerboard-like pattern” (n = 3) in the lesion appeared in T2-WI. In contrast-enhanced MRI images, all cases showed diffuse “striate pattern” enhancement. Among them, one case demonstrated “checkerboard-like pattern” enhancement. All cases had diffuse and prominent muscle edema that preserved the muscle fascicles. For two lesions located in the deep muscle group, the adjacent bone showed bone marrow edema. Conclusion MR imaging has unique advantages for diagnosis of early MO without calcification or ossification: the “striate pattern” and “checkerboard-like pattern” appearance shown in T2-WI and contrast-enhanced MRI images can be helpful for differential diagnosis. MRI can delineate the extent of the tumor and provides accurate anatomical information, which is important in diagnosis, treatment, and follow-up.

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Section: Discussionmentioning

confidence: 65%

MRI Findings of Early Myositis Ossificans without Calcification or Ossification

Wang

Nie

et al. 2018

BioMed Research International

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“…The chondrocytes of parosteal OS usually show more pleomorphism and occasional binucleation and a lack of regular columnar arrangement and polarity [9]. Myositis ossificans may be grossly similar to parosteal OS, radiographically, however, the ossification pattern of parosteal OS is generally centrally located whereas the ossification pattern of myositis ossificans is peripherally located [10]. In addition, lesions of parosteal OS on MRI are more hypointense both in T1-weighted and T2-weighted images [10].…”

Section: Discussionmentioning

confidence: 99%

“…Myositis ossificans may be grossly similar to parosteal OS, radiographically, however, the ossification pattern of parosteal OS is generally centrally located whereas the ossification pattern of myositis ossificans is peripherally located [10]. In addition, lesions of parosteal OS on MRI are more hypointense both in T1-weighted and T2-weighted images [10]. A high-grade surface OS is another entity that may be confused with parosteal OS.…”

Section: Discussionmentioning

confidence: 99%

A rare rib lesion due to parosteal osteosarcoma: a case report

et al. 2019

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IntroductionMasses which develop on the surface of the rib bones are rare. The differential diagnosis includes benign and malignant lesions.Case presentationA 23-year-old European woman presented at an out-patient clinic with a 9-month history of a painless swelling on the right posterolateral side of her chest wall. The case reported here is of a very rarely seen parosteal osteosarcoma of the rib that was treated with wide resection and chest wall reconstruction. There was no evidence of local recurrence or distal metastasis after a 1-year follow-up.ConclusionParosteal osteosarcoma is a locally aggressive malignant tumor, and resection with a wide margin is the most appropriate treatment. Correct diagnosis of parosteal osteosarcoma is challenging for an orthopedic surgeon. Although rare, in the differential diagnosis of lesions located on the ribs, parosteal osteosarcoma should be considered and a systematic diagnostic approach should be taken.

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“…To the best of our knowledge, it has not been reported previously that CAF contains these fatty signals in calcifications. In other entities such as myositis ossificans, it has been reported that fatty areas resembling the yellow bone marrow, appeared in calcified areas [11] . In diffuse idiopathic skeletal hyperostosis and ossification of the posterior longitudinal ligament, fatty signals can be seen in calcifying lesions on MRI [12] .…”

Section: Discussionmentioning

confidence: 99%

Calcifying aponeurotic fibroma in a girl: MRI findings and their chronological changes

Sekiguchi

Nakagawa

Miwa

et al. 2017

Radiology Case Reports

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Calcifying aponeurotic fibroma (CAF) is a rare benign tumor that typically develops in the fascia and tendons. On MRI, CAF usually shows isointensity on T1WI and heterogeneous high intensity on T2WI. We report a case of 17-month-old girl with CAF on her right ankle. MRI showed an usual signal intensity for CAF. At 3 years and 4 months of age, MRI revealed hyperintense nodules on T1WI and T2WI inside of the CAF. These fatty areas corresponded to coarse calcified nodules on CT. Radiologists should be aware of the fact that fat-like signals can appear in CAF on MRI.

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Myositis ossificans mimicking sarcoma, the importance of diagnostic imaging – case report

Cited by 26 publications

References 3 publications

MRI Findings of Early Myositis Ossificans without Calcification or Ossification

MRI Findings of Early Myositis Ossificans without Calcification or Ossification

A rare rib lesion due to parosteal osteosarcoma: a case report

Calcifying aponeurotic fibroma in a girl: MRI findings and their chronological changes

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