A Radiologic Study of Soft-Tissue Tumors

Abstract

ALTHOUGH there are many soft-tissue tumors that cannot be differentiated roentgenologically, there are many others presenting more or less characteristic features, and it is my purpose to describe these and to point out the distinguishing signs of the various groups. In a review of one hundred and three soft-tissue tumors, I found sixty-two benign and forty-one malignant. Clinical and Pathologic Data There are many types of lipomas, or fatty tumors, but I shall discuss only the subcutaneous type here. They arise from the subcutaneous layers, and are said to be most abundant over the trunk and the trunk ends. In this series two were in the region of the shoulder, six in the thigh, two in the forearm, and one over the inner aspect of the right ankle. The tumors, for the most part, are freely movable, soft, definitely encapsulated and lobulated, and not fluctuating. Fibro-lipomas, or fatty tumors rich in connective tissue, occurred as follows: two in the thigh, two in the leg and one in the forearm. These tumors are less soft, denser in consistency, and less inclined to be lobulated. The fibro-chondro-lipoma, a fatty tumor containing an increase of connective tissue and cartilage cells, firm, hard and more likely to be fixed, occurred in the thigh. The hemangiomas, tumors composed of newly formed vessels, which may or may not be thrombosed, occurred one on the internal surface of the right leg at the lower margin of the middle third of the tibia, and the other on the inner upper third of the leg. There was one lymphangioma, a tumor composed of newly formed lymph spaces and channels, extending over the upper four-fifths of the right leg. Myxoma, a soft translucent growth made up of variously shaped cells of connective tissue and capillary vessels encased in a jelly-like matrix, was seen once, in the plantar surface of the foot. One fibro-osteoma with secondary fibro-cytoplasia involved the tissues in the inner middle third of the thigh. A single xanthoma, a tumor consisting of fibrous and fatty tissue containing yellow pigment, was seen just below the head of the proximal phalanx of the middle finger on the radial side. Ordinarily an osteochondroma cannot be classified as a soft-tissue tumor, but there were three in this series. One arose from a knocked-off piece of the patella and lay just without the synovia, bulging into the knee joint; one arose by a pedicle just posterior to the lesser trochanter of the femur, and the third, apparently taking origin from the spinous process of the third cervical vertebra, was seen in the soft tissues of the neck. The latter was pathologically considered degenerating hemorrhagic osteoma. There was one chondroma involving the soft tissues of the thumb. Four of the series were aneurysms, three arterial, and one venous. One was in the inner middle third of the forearm, one directly over the right elbow joint, and two were in the thigh.