Primary Extremity Liposarcoma: MRI Features, Histopathology, and Clinical Outcomes. Issue 5 (September 2016)

• Record Type: Journal Article
• Authors: Wortman, Jeremy R.; Tirumani, Sree Harsha; Jagannathan, Jyothi P.; Tirumani, Harika; Shinagare, Atul B.; Hornick, Jason L.; Ramaiya, Nikhil H.
• Is Part Of: Journal of computer assisted tomography. Volume 40:Issue 5(2016)
• Publication Date: 2016-09
• Subjects: liposarcoma -- atypical lipomatous tumor -- dedifferentiated liposarcoma -- myxoid liposarcoma -- pleomorphic liposarcoma -- MRI; Tomography -- Periodicals; Tomography -- Periodicals; Tomography; Periodicals; 616.0757
• DOI: 10.1097/RCT.0000000000000431
• Languages: English
• ISSNs: 0363-8715

Abstract

Abstract : Objective: This study aimed to describe magnetic resonance imaging (MRI) features of extremity liposarcoma (LPS) subtypes, correlating with histopathology and clinical outcomes. Methods: In this retrospective study, we included 125 patients (80 men, 45 women; mean age, 53 years) with extremity LPS [23 atypical lipomatous tumor (ALT), 9 dedifferentiated (DDLPS), 70 myxoid (MLPS), 23 pleomorphic (PLPS)]. Pretreatment MRI of primary tumors in 56 patients (10 ALT, 4 DDLPS, 28 MLPS, 14 PLPS) was reviewed. Results: All subtypes were predominantly T1 isointense relative to skeletal muscle (DDLPS = 3/4, MLPS = 28/28, PLPS = 13/14) and T2 hyperintense (ALT = 10/10, DDLPS = 3/4, MLPS = 28/28, PLPS = 14/14) except for ALT which were T1 hyperintense (8/10). Within MLPS, high grade was associated with unencapsulated margins ( P = 0.05) and solid, nodular enhancement ( P < 0.0001). Peritumoral edema ( P = 0.03) and T2 heterogeneity ( P = 0.05) predicted pulmonary (rather than extrapulmonary) metastases in MLPS. Tumor subtype correlated with mortality ( P = 0.04). Conclusions: The MRI features can help to distinguish between extremity LPS subtypes, and can predict histopathologic grade and metastatic pattern in myxoid LPS.