Kaya Mitsunori, Wada Takuro, Nagoya Satoshi, Sasaki Mikito, Matsumura Tadaki, Yamaguchi Takehiko, Hasegawa Tadashi, Yamashita Toshihiko
Department of Orthopedic Surgery, Sapporo Medical University School of Medicine, S-1, W-16, Chuo-ku, Sapporo, 060-8543, Hokkaido, Japan.
Skeletal Radiol. 2008 Dec;37(12):1085-90. doi: 10.1007/s00256-008-0542-4. Epub 2008 Jul 16.
Myxofibrosarcoma often shows abnormal signal infiltration along the fascial plane on magnetic resonance imaging (MRI). The objective was to describe this MRI characteristic of myxofibrosarcoma with pathologic findings for comparison.
Clinical, histological, and imaging data for 21 patients with myxofibrosarcoma were reviewed retrospectively.
Seventeen tumors showed a diffuse infiltrative pattern on MRI. All tumors with diffuse infiltrative growth pattern showed borderless extension of atypical cells with moderate nuclear atypia to the muscle fascia. Notably, the remaining four patients with focal growth pattern on MRI also demonstrated infiltrative growth pattern histologically suggesting that myxofibrosarcoma shows an infiltrative growth property even in the lack of infiltrative growth pattern on MRI.
Most myxofibrosarcoma show an infiltrative growth pattern histologically. Orthopedic oncologist should pay careful attention to accurately assess tumor extension. It seems prudent to resect the entire area of abnormal signal extension seen on MRI whenever possible to obtain an adequate surgical margin of myxofibrosarcoma.
黏液纤维肉瘤在磁共振成像(MRI)上常显示沿筋膜平面的异常信号浸润。目的是描述黏液纤维肉瘤的这种MRI特征并与病理结果进行比较。
回顾性分析21例黏液纤维肉瘤患者的临床、组织学和影像学资料。
17个肿瘤在MRI上表现为弥漫浸润型。所有具有弥漫浸润性生长模式的肿瘤均显示非典型细胞无边界延伸至肌肉筋膜,核异型性中等。值得注意的是,其余4例MRI上呈局灶性生长模式的患者在组织学上也表现为浸润性生长模式,这表明黏液纤维肉瘤即使在MRI上缺乏浸润性生长模式时也具有浸润性生长特性。
大多数黏液纤维肉瘤在组织学上表现为浸润性生长模式。骨肿瘤学家应仔细注意准确评估肿瘤范围扩展。只要有可能,切除MRI上显示异常信号扩展的整个区域以获得足够的黏液纤维肉瘤手术切缘似乎较为谨慎。