Sonographic imaging features of alveolar soft part sarcoma: Case series and literature review

Abstract

Background: Alveolar soft part sarcoma (ASPS) is a rare tumor but potentially fatal condition. Understanding the imaging and clinical features of ASPS is of certain value for preoperative qualitative diagnosis and clinical treatment of tumors. Nevertheless, there have been only 11 documented case reports describing the sonographic features in the English literature.Methods: Three patients with confirmed ASPS occurring primarily in the limbs were enrolled in this study. Complete surgical excision was performed with conservative limb function. We pay particular attention to the ultrasonographic features and performed a literature review of ASPS cases.Results: With regular surveillance, one patient had no symptom recurrence and two developed lung and/or breast metastasis later. The specific sonographic findings were heterogeneous hypoechoic, well-circumscribed, and lobulated or round contours on grayscale images, abundant flow signals of intratumoral and extratumoral tubular structures on color Doppler images. Conclusion subsections:Its low incidence rate and lack of characteristic clinical manifestations often result in misdiagnosis of ASPS. The specific sonographic findings may add useful diagnostic information.

Imaging Features of Alveolar Soft Part Sarcoma: Single Institution Experience and Literature Review

“…Particular attention should be paid to US features since US is frequently the first imaging modality performed in the assessment of soft-tissue lumps. In this regard, our results are consistent with those of Li et al and concordant in defining the US appearance of ASPS as an inhomogeneous hypoechoic well-defined mass with strong vascularization [26]. Additionally, in our series, an arterial sonographic Doppler pattern was detected inside the peritumoral feeding vessels.…”

“…Fourteen articles (case series or original research) focusing on ASPS imaging were found, with a total of 151 patients included [2,3,[16][17][18][19][20][21][22][23][24][25][26][27][28]. We included studies with tumor location both at the extremities and in any other body region.…”

“…A recent literature review performed by Li et al reported that typical ASPS sonography features a heterogeneous hypoechoic appearance with well-defined margins, the presence of intra-and peri-tubular vessels, and high vascularization detected on color-Doppler assessment [26].…”

Qualitative and quantitative MRI analysis of alveolar soft part sarcoma: correlation with histological grade and Ki-67 expression

“…Magnetic resonance imaging (MRI) has emerged as a promising tool in this regard, capable of reflecting some clinical and pathological characteristics of ASPS. Typical MRI findings include slightly higher signal intensity on T1-weighted images (T1WI) and high signal intensity on T2-weighted images (T2WI) due to the tumor’s rich blood supply, which also manifests as tortuous and dilated vascular structures [ 2 ]. Intratumoral necrosis, infiltrative growth patterns, and tumor vascular cavities were discernible in MRI scans to aid in differentiating ASPS from other STSs [ 9 ].…”