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Mineralization in Musculoskeletal Leiomyosarcoma: Radiologic—Pathologic Correlation

Charles H. Bush1, John D. Reith2 and Suzanne S. Spanier2

1 Department of Radiology, University of Florida College of Medicine, P. O. Box 100374, Gainesville, FL 32610-0374.
2 Department of Pathology, University of Florida College of Medicine, P. O. Box 100275, Gainesville, FL 32610-0275.



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  		Fig. 1A. —52-year-old woman with primary leiomyosarcoma of right proximal tibia. Anteroposterior radiograph shows mildly expansile, reasonably well-defined lesion that contains sizable component of dense mineralization (arrows).

 


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  		Fig. 2A. —28-year-old man with primary leiomyosarcoma of right third rib. Posteroanterior radiograph obtained at presentation (not shown) showed subtle lytic lesion of right third rib. Axial unenhanced CT scan reveals faint mineralization (arrowheads) within tumor.

 


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  		Fig. 3A. —42-year-old man presented with left elbow leiomyosarcoma. Anteroposterior radiograph of left elbow reveals small, mineralized soft-tissue mass (arrow) in triceps.

 


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  		Fig. 3D. —42-year-old man presented with left elbow leiomyosarcoma. Axial CT scan obtained 9 months after B and C with IV contrast material shows enhancing soft-tissue mass (arrow) with peripheral enhancement and central mineralization (arrowhead).

 


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  		Fig. 4A. —54-year-old woman who presented with soft-tissue leiomyosarcoma of right elbow. Anteroposterior radiograph shows curvilinear region of ossification (arrow) at site of mass.

 


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  		Fig. 3B. —42-year-old man presented with left elbow leiomyosarcoma. Axial T1-weighted (B) and T2-weighted (C) MR images obtained 6 weeks after A show mass to be of mostly low signal intensity (arrow). Patient was lost to follow-up for 9 months, when CT and MR imaging were performed again.

 


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  		Fig. 3C. —42-year-old man presented with left elbow leiomyosarcoma. Axial T1-weighted (B) and T2-weighted (C) MR images obtained 6 weeks after A show mass to be of mostly low signal intensity (arrow). Patient was lost to follow-up for 9 months, when CT and MR imaging were performed again.

 


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  		Fig. 4B. —54-year-old woman who presented with soft-tissue leiomyosarcoma of right elbow. T2-weighted MR image shows low-signal-intensity region of ossification inside larger soft-tissue mass (arrowheads). Center of this ossific region contained tissue (arrow) that was isointense to fat on all sequences. Tumor was irradiated before resection.

 


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  		Fig. 1B. —52-year-old woman with primary leiomyosarcoma of right proximal tibia. Photomicrograph of histologic section from leiomyosarcoma shows that dense, cortical-type bone (arrows) is centrally located in tumor. (H and E, x200)

 


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  		Fig. 1C. —52-year-old woman with primary leiomyosarcoma of right proximal tibia. Photomicrograph of histologic section from tumor shows dense, dystrophic mineralization (arrows) in different part of tumor. (H and E, x400)

 


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  		Fig. 2B. —28-year-old man with primary leiomyosarcoma of right third rib. Posteroanterior radiograph obtained at presentation (not shown) showed subtle lytic lesion of right third lib. Photomicrograph of histologic section from tumor shows reactive bone (arrows) throughout tumor. (H and E, x200)

 


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  		Fig. 4C. —54-year-old woman who presented with soft-tissue leiomyosarcoma of right elbow. Photomicrograph of histologic section from excised tumor shows leiomyosarcoma of soft tissue with area of ossification (arrows) seen on radiograph (A) and MR image (B) containing fatty marrow (F). T = tumor. (H and E, x100)

 

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