Radiologic-Pathologic Conferences of the Massachusetts General Hospital

Myxoid Liposarcoma of the Thigh

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Michelle 6. Ramsdell1, Felix S. Chew1, Suzanne B. Keel2

A 39-year-old
a right thigh
man
mass.
presented
Radiographs
with tients younger
fibrous histiocytoma
than 26 years
is more common
and malignant
in pa-
tenuation
teristics
on CT and signal
similar to subcutaneous
intensity
fat on MR
charac-

showed a soft-tissue mass in the tients older than 45 years; however, liposar- images. The higher-grade lesions frequently
posterior thigh with radiolucent components coma is actually more prevalent in the fifth have no radiologically evident fat [2]. Large
(Fig. 1A). CT showed a heterogeneous fat- and sixth decades [1]. Liposarcoma usually size, lobular shape, circumscription, hetero-
containing lesion displacing the muscles and arises in the deep soft tissues, and patients geneous enhancement, hemorrhage, and ne-
neurovascular structures of the posterior present with a large painless mass. Despite crosis are common features of liposarcomas.
compartment (Fig. lB). On MR images, the its name, liposarcoma is not derived from Soft-tissue sarcomas of other histologic
mass was heterogeneously enhancing, with mature fat, but rather originates from a types may also contain fat as the result of
some of the same signal intensity characteris- primitive mesenchymal cell. Several mor- engulfment, especially in recurrent lesions.
tics as fat (Fig. lC). MR imaging also showed phologic subtypes exist, all with histologic Liposarcomas are treated surgically with
the lobular morphology of the mass, hemor- evidence of fat differentiation. The well-dif- wide margins. Local adjuvant radiation
rhage, and necrosis. The lesion was resected. ferentiated and myxoid subtypes are low or therapy may allow a limb-sparing operation
On pathologic examination, the tumor ap- intermediate grade and typically have large [3].
peared gelatinous. Microscopy revealed a amounts of gross fat or extracellular myxoid
delicate network of branching blood vessels material, while the round cell, pleomorphic,
within a myxoid matrix, with occasional sig- and dedifferentiated subtypes are considered References
net-ring cells (Fig. 1D). The final pathologic high grade and typically are very cellular, I . Kransdorf M, Murphey MD. Imaging of soft tis-

diagnosis was low-to-intermediate grade myx- with little (if any) gross fat. Although radio- sue tumors. Philadelphia: Saunders, 1997:79-94
2. Jelinek JS, Kransdorf Mi, Shmookler BM, Abou-
oid liposarcoma. graphs usually show a nonspecific soft-tis-
lafia AJ, Malewer MM. Liposarcoma of the cx-
Liposarcoma is the most common soft- sue mass, the appearance of liposarcoma on
tremities: MR and CT findings in the histologic
tissue sarcoma of the lower extremities in CT and MR imaging tends to reflect the de- subtypes. Radiology 1993; 186:455-459.
adults between the ages of 26 and 45 years. gree of fat differentiation. The lower-grade 3. Springfield DS. Liposarcoma. C/in Orthop Re/at
Synovial sarcoma is more common in pa- lesions generally appear fatlike, with low at- Res 1993:289:50-57

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D

Fig. 1.-Myxoid liposarcoma ofthigh in 39-year-old man.

A, Lateral radiograph shows large fat-containing soft-tissue mass.
B, CT scan shows location of mass in posterior compartment.
C, 11-weighted sagittal MR image shows lobular shape and heterogeneous signal intensity of mass, with some portions similar to fat.
D, Photomicrograph shows delicate vascular network, adipocytes, and primitive mesenchymal cells embedded within myxoid matrix. (H and E, high power)

From the weekly radiologic-pathologic correlation conferences conducted by Jack Wittenberg. Pathology editor: Andrew E. Rosenberg.
1 Department of Radiology, Massachusetts General Hospital and Harvard Medical School, 32 Fruit St., Boston, MA 02114. Address correspondence to F. S. Chew.

2Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114.
AJR 1998;170:1242 0361-803X/98/1705-1242 © American Roentgen Ray Society

1242 AJR:170, May 1998

 This article has been cited by:

1. Julia C.W. Lake, Edison Tsui, Jennifer Wu, Michael Baker, Kelly Kieffer. 2019. Case reports of diagnostic error: liposarcoma
mistaken for hematoma in an obese female with concurrent ipsilateral thrombosis on rivaroxaban. Diagnosis 6:3, 301-305.
[Crossref]
2. Ukihide Tateishi, Tadashi Hasegawa, Yasuo Beppu, Akira Kawai, Mitsuo Satake, Noriyuki Moriyama. 2004. Prognostic
Significance of MRI Findings in Patients with Myxoid–Round Cell Liposarcoma. American Journal of Roentgenology 182:3,
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