Sarcomas of Soft Tissue (Continued)
Diagnostic Studies. Liposarcoma is best imaged by MRI and will have at least some fat with high signal intensity on T1-weighted images. Dedifferentiated liposarcomas will have a large area of…
Sarcomas of Soft Tissue
Limb-salvage procedures (i.e., local excision) have replaced amputation as the primary treatment of soft tissue sarcomas; however, despite the efficacy of limb-salvage procedures in obtaining local control, pulmonary metastases remain…
Lipoma, Neurofibroma, and Myositis Ossificans
Diagnostic Studies. Radiographs may also show calcification in areas of necrosis and metaplastic bone or cartilage inside lipomas. MRI reveals a homogenous fatty tumor that can be quite large. Treatment/Prognosis….
Desmoid, Fibromatosis, and Hemangioma
Diagnostic Studies. On MRI, tumor margins are sometimes difficult to distinguish from the normal fascial structures. Treatment/Prognosis. Treatment of desmoids has historically been by excision or resection, but based on…
Tumors Metastatic to Bone
Purely osteolytic metastases are generally from lung, kidney, thyroid, or colon cancer. Metastatic bone tumors from kidney or thyroid carcinoma are usually hypervascular, and preoperative embolization should be considered. Osteoblastic…
Adamantinoma
Diagnostic Studies. The radiographic appearance consists of multiple small, oval, radiolucent cortical defects with a distinct margin of reactive bone and a thickened cortex. Adamantinoma typically has a “soap bubble”…
Reticuloendothelial Tumors—Ewing Sarcoma
Diagnostic Studies. Radiographs show a permeative usually diaphyseal tumor with a mottled, or patchy, density that indicates the tumor’s destructive nature. Cortical involvement frequently produces a reactive, “onionskin” appearance of…
Reticuloendothelial Tumors— Myeloma
Diagnostic Studies. The results of most staging studies are the same as for other malignant primary tumors. On bone scans, however, myelomas may not appear as abnormal (cold lesions). Laboratory…
Fibrous Histiocytoma and Fibrosarcoma of Bone
MALIGNANT FIBROUS HISTIOCYTOMA Malignant fibrous histiocytoma occurs less often in bone than in soft tissues. It usually presents as an aggressive stage IIB sarcoma; not infrequently, a pathologic fracture is…
Osteosarcoma (Continued)
Histologic features consist of mature trabeculae with a peculiar pattern of cement lines similar to that seen in Paget disease of bone. Enmeshed in a low-grade stroma, the trabeculae often…
