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Dedifferentiated liposarcoma of the musculoskeletal system: expanded MR imaging spectrum from predominant fatty mass to non-fatty mass

Jae Sung Yun, Hye Won Chung, Joon Seon Song, Sang Hoon Lee, Min Hee Lee, Myung Jin Shin
Acta Radiologica 2019 March 24, : 284185119833060

BACKGROUND: The morphology of musculoskeletal dedifferentiated liposarcoma was previously reported as well-defined non-lipomatous masses juxtaposed with fatty tumors.

PURPOSE: To establish a new spectrum of magnetic resonance imaging (MRI) findings for dedifferentiated liposarcoma according to the quantity and distribution of the non-fatty component in the tumor.

MATERIAL AND METHODS: This study consisted of a retrospective review of MRI of 14 patients with a total of 18 histopathologically proven dedifferentiated liposarcoma lesions in the musculoskeletal area. Tumors were classified into four categories (I-IV) according to MR features: I = a well-defined fatty mass and juxtaposed well-defined non-fatty mass; II = a non-fatty component within a predominant fatty mass; III = a focal fatty component within a large non-fatty mass; and IV = a non-fatty mass. Tumor size and depth were also analyzed.

RESULTS: The MR categorizations of the tumors were as follows: Category I, n = 3; Category II, n = 1; Category III, n = 7; and Category IV, n = 7. The mean tumor size was 11.9 cm (range = 5.0-22.2 cm). Most of the tumors showed a predominant non-fatty area and were deeply located at the intra- or intermuscular space.

CONCLUSION: Dedifferentiated liposarcoma lesions showed a diverse spectrum of MRI findings. Although the presence of a non-fatty region within or adjacent to a well-defined fatty mass can suggest dedifferentiated liposarcoma, non-fatty masses without a fatty component were frequent on MRI.


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