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Age / Sex : 39 / F
Age/Sex: 39/F
C.C.: Palpable mass in left thigh
1) What is your impression?
Two weeks later, you can see the final diagnosis with a brief discussion of this case.
* Send Application Answers to Ja-Young Choi, MD (drchoi01@gmail.com)
Courtesy : Soo-Jung Choi, M.D., GangNeung Asan Hospital
Diagnosis: myxoid liposarcoma
Discussion
Findings:
US shows heterogenous hyperechoic mass with increased internal vascularity. MR signal intensity of the mass is very high signal intensity on T2WI like cyst, but the lesion is strongly enhanced after Gd enhancement.
Differential Diagnosis:
myxoid liposarcoma/myxoid MFH/myxoma
Diagnosis: Myxoid Liposarcoma
Discussion:
Myxoid liposarcoma is the most common type of liposarcoma, representing 30%–40% of all liposarcomas in the extremities. Myxoid liposarcoma occurs most commonly in the lower extremity, particularly the thigh. On T1-weighted images, most myxoid liposarcomas exhibit high-signal-intensity foci representing fat within a predominantly homogeneous low-signal-intensity mass, but some of them may not exhibit the signal intensity typical of a fatty tumor like in this case. On T2-weighted images, they have characteristic signal intensity; prominent high signal intensity like cystic lesion, but T1-weighted images after enhancement show heterogeneous enhancement, indicating a solid mass. The differential diagnosis of myxoid liposarcoma has to include all soft tissue tumors contain myxoid tissue; myxoid chondrosarcoma, myxoid MFH, intramuscular myxoma.
References:
1. Bredella MA, Stoller DW, Johnston JO. Bone and soft-tissue tumors. In; Stoller DW. Magnetic resonance imaging in orthopaedics and sports medicine, 3rd ed, Philadelphia; Lippincott Williams & Wilkins, 2007:2140-2143.
2. Sung MS, Kang HS, Suh JS, et al. Myxoid liposarcoma: appearance at MR imaging with histologic correlation. Radiographics. 2000;20(4):1007-19.
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