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Role of electron microscopy in the evaluation of soft tissue neoplasms, with emphasis on spindle cell and pleomorphic tumors.

The current significant role of transmission electron microscopy in the evaluation of soft tissue tumors when correlated with conventional histological and immunohistochemical studies is discussed for the following entities: myxofibrosarcoma, storiform-pleomorphic fibrosarcoma (malignant fibrous histiocytoma), and myofibrosarcoma; dermatofibrosarcoma protuberans; hemangiopericytoma; monophasic synovial sarcoma; extrarenal rhabdoid tumor; soft tissue perineurioma; and gastrointestinal stromal tumors, notably the so-called autonomic nerve variant.

Adult↗

Imaging of Soft Tissue Neoplasms in the Adult: Benign Tumors.

This discussion reviews the spectrum of benign soft tissue tumors usually found in adults. Lesions most commonly identified in the pediatric population, tumorlike masses, and malignant tumors are discussed in other articles in this issue. Rather than presenting a complete review, the focus of this article is on benign tumors in which the diagnosis may be confidently made or strongly suggested on the basis of imaging. Diagnoses presented include those for lipoma, lipoma variants, giant cell tumor of the tendon sheath, pigmented villonodular synovitis, superficial and deep fibromatoses, elastofibroma, and peripheral nerve sheath tumors.

Journal Article↗

Imaging of Soft Tissue Neoplasms in the Adult: Malignant Tumors.

This review discusses the spectrum of malignant soft tissue tumors usually found in adults. Lesions most commonly identified in the pediatric population, as well as tumorlike masses, are not covered. Rather than presenting a complete review, the focus of this discussion is on common lesions and those lesions in which the diagnosis may be suggested on the basis of imaging. Diagnoses covered include malignant fibrous histiocytoma, fibrosarcoma, dermatofibrosarcoma protuberans, liposarcoma, synovial sarcoma, malignant peripheral nerve sheath tumor, leiomyosarcoma, aggressive vascular tumors, extraskeletal chondrosarcoma and osteosarcoma, lymphoma, and metastatic carcinoma.

Journal Article↗

Radionuclide imaging of soft tissue neoplasms.

Two classes of radiopharmaceuticals may be used for imaging tumors of the musculoskeletal system. The first is comprised of soft tissue or tumor specific agents such as gallium-67, bleomycin, and radionuclide-labeled antibodies, which may be useful for detecting and localizing these tumors. The other class of tracer is comprised of those with avidity for bone. The 99mTc-labeled-phosphate skeletal imaging compounds have been found to localize in a variety of soft tissue lesions, including benign and malignant tumors. In 1972, Enneking began to include bone scans in the preoperative evaluation of soft tissue masses. Later, he and his associates reported that these scans were useful in planning operative treatment of sarcomas by detecting involvement of bone by the tumors. Nearly all malignant soft tissue tumors take up bone-seeking radiopharmaceuticals, and bone involvement was indicated in two-thirds of the scans we reviewed. About half of benign soft tissue lesions had normal scans, but the other half showed uptake within the lesion and a few also showed bone involvement. Careful, thorough imaging technique is essential to proper evaluation. Multiple, high-resolution static gamma camera images in different projections are necessary to adequately demonstrate the presence or absence of soft tissue abnormality and to define the precise relationship of the tumor to the adjacent bone.

Bleomycin↗