Abstract
PurposeMany surgeons participate in the management of superficial soft tissue masses, and a preoperative incorrect diagnosis frequently results in dismal oncological outcomes. The aim of this study was to identify distinguishing magnetic resonance imaging features between malignant and non-malignant lesions.MethodsThe clinicopathological data for 219 patients (men 114; women 105) with superficial soft tissue masses treated from January 2007 to December 2016 in our institution were retrospectively analyzed. The median age at the first visit was 55.6 years (range 1–90 years). MRI findings of tumor size, margin, lobulation, intratumoral hemorrhage, peritumoral edema, and tumor-fascia relationship were compared with the final histological diagnosis and tumor grade.ResultsUnivariate analysis revealed significant relationships between histologically malignant lesions and tumor size ≥5 cm (p = 0.035), positive peritumoral edema (p = 0.031), and tumor-fascia relationship (p<0.001), but not margin (p = 0.107), lobulation (p = 0.071), and intratumoral hemorrhage (p = 0.17). In addition, using multivariate analysis, the tumor-fascia relationship (p<0.001) and tumor size were significant factors.A significant correlation between tumor-fascia relationship and malignancy (p<0.001) was observed; such a relationship was, however, not observed for tumor grade (p = 0.43).ConclusionsTumors measuring ≥5 cm and the tumor-fascia relationship on magnetic resonance imaging are highly indicative of malignancy. When superficial soft tissue masses cross the superficial fascia and form obtuse angles with the fascia, sarcoma should be considered. The tumor-fascia relationship can offer surgeons useful information regarding the status of superficial soft tissue masses.
Highlights
Soft tissue sarcomas are rare malignancies, and constitute less than 1% of all malignant tumors [1] Most superficial soft tissue sarcomas occur in the extremities [2]
Tumors measuring 5 cm and the tumor-fascia relationship on magnetic resonance imaging are highly indicative of malignancy
Diagnostic value of tumor-fascia relationship superficial fascia and form obtuse angles with the fascia, sarcoma should be considered
Summary
Soft tissue sarcomas are rare malignancies, and constitute less than 1% of all malignant tumors [1] Most superficial soft tissue sarcomas occur in the extremities [2]. Superficial masses include primary soft tissue sarcomas, metastatic tumors, benign tumors, and non-neoplastic lesions such as bursitis and ganglions. Magnetic resonance imaging (MRI) is the main imaging modality for evaluation of soft tissue tumors [4]. MRI contributes towards a specific pathological diagnosis or a narrow differential diagnosis on the basis of the signal intensity [5], its ability to distinguish between benign and malignant soft tissue tumors remains to be debated [6]. Little information regarding the MRI features of superficial soft tissue masses is available. The aim of our study was to identify characteristic factors for differentiation between malignant and nonmalignant lesions, and to analyze the correlation between the tumor-fascia relationship and malignant tumors. We focused on the MRI features of subcutaneous soft tissue masses
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
