The MR imaging appearances and natural history of seromas following excision of soft tissue tumours

Abstract

Fluid collections (seromas) may accumulate at the site of surgery following excision of musculoskeletal soft tissue tumours. The aim of this retrospective study was to review the magnetic resonance (MR) imaging features of postoperative seromas identifying changes over time on follow-up scans. A total of 170 MR scans from 80 patients were reviewed showing one or more seromas. All patients had undergone previous surgery for a musculoskeletal soft tissue tumour. The typical MR appearances of a seroma were shown to be a well-defined oval or rounded (54%) soft tissue mass, arising at the site of previous surgery, with a thin, dark pseudocapsule, surrounding soft tissue oedema (80%), homogeneous contents that are hypointense (relative to adjacent muscle) on T1-weighted images (74%) and hyperintense on T2-weighted and STIR images (79%). Approximately one-quarter of cases revealed atypical features including hyperintense contents on T1-weighted (26%) and/or heterogeneous contents on T2-weighted images (21%), reflecting the breakdown of blood products and organization of the fluid collection. A distinctive fine feathery pattern arising from the inner surface of the seroma or from septations was identified in 10% of cases. In those patients who underwent one or more follow-up scans, the volume of the seromas decreased in 66% cases, remained unchanged in 15% and increased in 19%. Seromas are not an uncommon finding (<10% of cases) following surgery for a soft tissue tumour. The majority of cases show the typical MR features of a fluid collection. The pitfalls in differentiating an atypical seroma from a recurrent soft tissue sarcoma are discussed.

Posttraumatic pseudolipoma: MRI appearances

“…The major drawback of liposuction is the absence of a pathologic specimen that confirms the nature of the deformity. Possible complications could be postoperative seromas, which were not evident in the only postoperative MRI eyxamination performed [21]. In our institution, selective liposuction is classically performed using the blunt dissection technique of Illouz [22].…”

Tumor Bed Delineation for Partial Breast and Breast Boost Radiotherapy Planned in the Prone Position: What Does MRI Add to X-ray CT Localization of Titanium Clips Placed in the Excision Cavity Wall?

“…Studies in postoperative sarcoma and prostate patients have pathologically correlated high signal-intensity on T2-weighted (T2W) images with seroma/ haematoma (13), heterogeneous signal change (hyperintense on T1-weighted (T1W) and hypointense on T2W) with organizing haematoma (14,15) and non-enhancing low signal on T1W with fibrosis (16). The appearances of post-operative cavities following wide-local excision of breast cancer have been described, using a low-field open MRI scanner, as heterogeneous ellipsoidal fluid-filled cavities with irregular borders (17).…”

A New Modification of Combining Vacuum Therapy and Brachytherapy in Large Subfascial Soft –Tissue Sarcomas of the Extremities

“…In BT, distension of the distance between applicators and tissue at high risk of recurrence might significantly deteriorate the intended dose distribution [2,9,21]. To prevent the development of a seroma and to induce wound healing, application of a vacuum system has proven to be successful [3,16,17,23].…”