Low-Grade Myxofibrosarcoma: CT and MRI Patterns in Recurrent Disease
Brendan Waters1,2,
David M. Panicek1,3,
Robert A. Lefkowitz1,3,
Cristina R. Antonescu4,
John H. Healey3,5,
Edward A. Athanasian3,5 and
Murray F. Brennan3,6
1 Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York
Ave., New York, NY 10021.
2 Present address: Department of Radiology, Potomac Hospital, Woodbridge,
VA.
3 Weill Medical College of Cornell University, New York, NY.
4 Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York,
NY.
5 Division of Orthopaedic Surgery, Memorial Sloan-Kettering Cancer Center, New
York, NY.
6 Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York,
NY.
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Fig. 1A —67-year-old man with recurrent low-grade myxofibrosarcoma. Axial
fat-suppressed T2-weighted MR image shows heterogeneous, masslike recurrence
with predominantly high signal in anterior aspect of right shoulder with
well-defined margins. H = humeral head.
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Fig. 1B —67-year-old man with recurrent low-grade myxofibrosarcoma. Axial
fat-suppressed T2-weighted MR image obtained 12 months after resection of
recurrence in A shows another recurrent tumor (white arrows)
in anterior right chest wall and axilla, now with multinodular configuration.
Note tail-like margin (black arrows).
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Fig. 2A —63-year-old man with recurrent low-grade myxofibrosarcoma. Sagittal
proton density (A) and axial fat-suppressed T2-weighted (B) MR
images of forearm show elongated, fusiform recurrence (thin arrows)
in subcutaneous tissues (superficial spreading configuration). Tail-like
margin (thick arrow, A) is evident at caudal extent
of lesion in A. In B, note very high signal throughout lesion,
typical of myxoid matrix. Asterisk in A =skin marker.
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Fig. 2B —63-year-old man with recurrent low-grade myxofibrosarcoma. Sagittal
proton density (A) and axial fat-suppressed T2-weighted (B) MR
images of forearm show elongated, fusiform recurrence (thin arrows)
in subcutaneous tissues (superficial spreading configuration). Tail-like
margin (thick arrow, A) is evident at caudal extent
of lesion in A. In B, note very high signal throughout lesion,
typical of myxoid matrix. Asterisk in A =skin marker.
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Fig. 3 —66-year-old woman with recurrent low-grade myxofibrosarcoma. Axial
fat-suppressed T2-weighted MR image shows pronounced taillike margins
(arrows) and well-defined and infiltrative margins of tumor
recurrence in forearm.
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Fig. 4 —75-year-old woman with recurrent low-grade myxofibrosarcoma. Axial
fat-suppressed T2-weighted MR image shows tumor (arrows) invading
subjacent tibia, replacing tibial marrow (T). Extensive region of high signal
anteriorly, laterally, and medially represents edematous myocutaneous
flap.
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Fig. 5A —Three patients with recurrent low-grade myxofibrosarcoma and distant
metastases. In 56-year-old man, contrast-enhanced CT image shows metastases to
right-sided pleura (arrow) and both adrenal glands
(asterisks). Primary tumor had been in subcutaneous tissues of
back.
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Fig. 5B —Three patients with recurrent low-grade myxofibrosarcoma and distant
metastases. In 77-year-old woman (same patient as in
Fig. 4 at follow-up 2 years
later), contrast-enhanced CT image reveals lytic metastasis in right iliac
bone with associated large extraosseous soft-tissue mass (M) in iliac fossa
and buttock. Other lytic metastases are evident in left iliac bone
(arrows), and metastasis was present in left adrenal gland (not
shown). Primary tumor had been in right calf.
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Fig. 5C —Three patients with recurrent low-grade myxofibrosarcoma and distant
metastases. In 40-year-old man, contrast-enhanced CT images show infiltrative
metastasis (arrows, C) in omentum and peritoneum (C)
that also involves small-bowel loop (arrow, D). CT image
obtained 11 months after C and D (E) shows another
metastasis (arrows, E) that involves peritoneum and anterior
abdominal wall. Primary tumor had been in left groin.
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Fig. 5D —Three patients with recurrent low-grade myxofibrosarcoma and distant
metastases. In 40-year-old man, contrast-enhanced CT images show infiltrative
metastasis (arrows, C) in omentum and peritoneum (C)
that also involves small-bowel loop (arrow, D). CT image
obtained 11 months after C and D (E) shows another
metastasis (arrows, E) that involves peritoneum and anterior
abdominal wall. Primary tumor had been in left groin.
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Fig. 5E —Three patients with recurrent low-grade myxofibrosarcoma and distant
metastases. In 40-year-old man, contrast-enhanced CT images show infiltrative
metastasis (arrows, C) in omentum and peritoneum (C)
that also involves small-bowel loop (arrow, D). CT image
obtained 11 months after C and D (E) shows another
metastasis (arrows, E) that involves peritoneum and anterior
abdominal wall. Primary tumor had been in left groin.
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Copyright © 2007 by the American Roentgen Ray Society.
