Brisse Hervé, Orbach Daniel, Klijanienko Jerzy, Fréneaux Paul, Neuenschwander Sylvia
Imaging Department, Institut Curie, 26 rue d'Ulm, 75005, Paris, France.
Eur Radiol. 2006 May;16(5):1147-64. doi: 10.1007/s00330-005-0066-4. Epub 2006 Jan 13.
The diagnosis of a soft tissue mass in children is a common clinical situation. Most of the lesions are benign and can be treated conservatively or by non-mutilating surgery. Nevertheless, the possibility of a malignant soft tissue tumor must be systematically considered. The most frequent benign soft tissue lesions in children are vascular lesions, fibrous and fibrohistiocytic tumors and pseudotumors, whereas rhabdomyosarcomas account for 50% of all soft tissue sarcomas. A child presenting an atypical soft tissue mass should be managed by a multidisciplinary centre, and primary resection must be proscribed until a definite diagnosis has been established. The role of imaging is essential either to confirm the benign nature of the mass or to give arguments to perform a diagnostic biopsy. Clinical examination, conventional radiography and ultrasound with Doppler represent the first-line examinations and are sometimes sufficient to assess a diagnosis. In all other situations, MRI is mandatory to establish the probable nature of the lesion and to assess local extension.
儿童软组织肿块的诊断是一种常见的临床情况。大多数病变是良性的，可以采用保守治疗或非致残性手术治疗。然而，必须系统地考虑恶性软组织肿瘤的可能性。儿童最常见的良性软组织病变是血管病变、纤维性和纤维组织细胞性肿瘤及假瘤，而横纹肌肉瘤占所有软组织肉瘤的50%。出现非典型软组织肿块的儿童应由多学科中心进行管理，在明确诊断之前，必须禁止进行初次切除。影像学检查的作用至关重要，它既可以确认肿块的良性性质，也可以为进行诊断性活检提供依据。临床检查、传统X线摄影和多普勒超声是一线检查方法，有时足以评估诊断。在所有其他情况下，必须进行磁共振成像（MRI）以确定病变的可能性质并评估局部扩展情况。
