“…For example Seo et al demonstrated sensitivity and specifity rates of 80%/97% in soft-tissue lesions and 85%/99% in bony lesions respectively in a series of 15 patients [ 30 ]. Stevenson et al reported 28 patients who received whole-body MRI and CT. Of 38 lesions found on MRI, 29 were located inside a corresponding CT field of view but only 5 of 8 soft-tissue lesions and none of 21 bony lesions were detected [ 31 ]. Fig.…”
BackgroundLiposarcomas are the second most common type of soft tissue sarcomas, 30–50% of these are of myxoid subtype. The aim of this retrospective study was to analyze the local control rate, the metastatic pattern and survival of patients in a consecutive single-institution series.MethodsFrom 1983 to 2015, 43 patients with myxoid liposarcoma of the extremities and trunk wall underwent resections. The margin was defined as R0 (wide) or R1 (marginal). Patients were followed for evidence of local recurrence or distant metastasis. Overall and recurrence-free survival was calculated.ResultsThe mean age was 48.6 years. The lower extremity was involved in 40 cases, the mean tumour size was 12 cm. In 31 cases a wide and in 12 cases a marginal resection was performed. Grading was G1 in 14, G2 in 25 and G3 in 4 cases.Nine patient died in follow-up, 4 of them with metastatic disease, all nonpulmonary. 5-year local recurrence (LR) free survival was 82%. 4 (9.3%) patients developed LR (all R1). Overall survival (OS) was 81% after 5 and 72% after 10 years. In multivariate analysis age and Grading proved to be significant on OS. According to univariate analysis, only age over 48 years and distant metastasis had a significant impact on overall survival.ConclusionsPatients with myxoid liposarcomas have a good prognosis. Myxoid liposarcoma has a distinct pattern of nonpulmonary metastatic disease. Therefore, patients with high-risk extremity myxoid liposarcoma should undergo imaging studies of the chest, abdomen, spine and pelvis as part of their staging and follow-up examinations preferably with whole body MRI, or CT scans and MRI of the spine and pelvic region for detection of suspected metastatic disease.
“…For example Seo et al demonstrated sensitivity and specifity rates of 80%/97% in soft-tissue lesions and 85%/99% in bony lesions respectively in a series of 15 patients [ 30 ]. Stevenson et al reported 28 patients who received whole-body MRI and CT. Of 38 lesions found on MRI, 29 were located inside a corresponding CT field of view but only 5 of 8 soft-tissue lesions and none of 21 bony lesions were detected [ 31 ]. Fig.…”
BackgroundLiposarcomas are the second most common type of soft tissue sarcomas, 30–50% of these are of myxoid subtype. The aim of this retrospective study was to analyze the local control rate, the metastatic pattern and survival of patients in a consecutive single-institution series.MethodsFrom 1983 to 2015, 43 patients with myxoid liposarcoma of the extremities and trunk wall underwent resections. The margin was defined as R0 (wide) or R1 (marginal). Patients were followed for evidence of local recurrence or distant metastasis. Overall and recurrence-free survival was calculated.ResultsThe mean age was 48.6 years. The lower extremity was involved in 40 cases, the mean tumour size was 12 cm. In 31 cases a wide and in 12 cases a marginal resection was performed. Grading was G1 in 14, G2 in 25 and G3 in 4 cases.Nine patient died in follow-up, 4 of them with metastatic disease, all nonpulmonary. 5-year local recurrence (LR) free survival was 82%. 4 (9.3%) patients developed LR (all R1). Overall survival (OS) was 81% after 5 and 72% after 10 years. In multivariate analysis age and Grading proved to be significant on OS. According to univariate analysis, only age over 48 years and distant metastasis had a significant impact on overall survival.ConclusionsPatients with myxoid liposarcomas have a good prognosis. Myxoid liposarcoma has a distinct pattern of nonpulmonary metastatic disease. Therefore, patients with high-risk extremity myxoid liposarcoma should undergo imaging studies of the chest, abdomen, spine and pelvis as part of their staging and follow-up examinations preferably with whole body MRI, or CT scans and MRI of the spine and pelvic region for detection of suspected metastatic disease.
“…Myxoid/round cell liposarcoma has a tendency to metastasize to extrapulmonary sites, specifically, soft tissue and skeletal sites such as the mediastinum and the retroperitoneum [ 12 , 13 ]. With the potential to metastasize to distant sites, prompt diagnosis as well as providing the best possible treatment options is critical [ 14 ].…”
Myxoid liposarcoma is the second most common type of liposarcoma that typically presents in the lower extremities and has a predilection for men. Manifestation of this tumor in the lower back is rare. We report the first known case of an adult woman presenting with a soft tissue mass in her lower back. Following excision and further workup, the mass was positive for rearrangements of the DDIT3 (CHOP) gene at the 12q13 locus, consistent with the diagnosis of a myxoid liposarcoma. The tumor was noted to be intramuscular and extended into the margins, requiring re-excision at the previous resection site. Biopsy of the re-excised area was negative for evidence of residual myxoid liposarcoma. We report this case to highlight the importance of considering myxoid liposarcoma as a differential diagnosis in soft tissue masses presenting in the lower back.
“…WB-MRI is therefore a useful tool for staging of these tumors and can identify more sites of metastatic disease and characterize the lesions more accurately when compared with standard CT or in some cases even PET/CT imaging. [77][78][79] Bosma et al advised caution when using 18F-FDG-PET/CT for diagnosing skeletal metastases in Ewing's sarcoma. The poor contrast between metastases and background active Whole-body magnetic resonance imaging (WB-MRI) (c-e) for staging in a 56-year-old woman with symptomatic multiple myeloma (anaplastic hyposecretory).…”
Section: Soft Tissue and Bone Sarcoma (Including Ewing's Sarcoma) Andmentioning
Whole-body magnetic resonance imaging (WB-MRI) is gradually being integrated into clinical pathways for the detection, characterization, and staging of malignant tumors including those arising in the musculoskeletal (MSK) system. Although further developments and research are needed, it is now recognized that WB-MRI enables reliable, sensitive, and specific detection and quantification of disease burden, with clinical applications for a variety of disease types and a particular application for skeletal involvement. Advances in imaging techniques now allow the reliable incorporation of WB-MRI into clinical pathways, and guidelines recommending its use are emerging. This review assesses the benefits, clinical applications, limitations, and future capabilities of WB-MRI in the context of other next-generation imaging modalities, as a qualitative and quantitative tool for the detection and characterization of skeletal and soft tissue MSK malignancies.
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