Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
Semin Ultrasound CT MR. 2020 Apr;41(2):222-238. doi: 10.1053/j.sult.2020.01.002. Epub 2020 Feb 15.
Soft-tissue sarcomas are a diverse group of rare mesenchymal malignancies accounting for only 1% of all solid adult malignancies. These have been categorized in 12 broad groups by the World Health Organization (WHO) with their recent update in 2013. Majority of them lack specific imaging features serving as imaging conundrums for a radiologist. These are often large masses at presentation as they are asymptomatic or cause vague clinical symptoms. These tumors are challenging for surgeons as well as they find it difficult to achieve complete resection because of complex intra-abdominal anatomy and their close relationship with critical structures. Often, a multidisciplinary approach is required to decide on the most appropriate management for these complex cases so as to provide optimal patient care. Knowledge of the WHO classification, pathologic features and available treatment options will help the radiologist make a meaningful contribution in multidisciplinary discussions of such cases and overall patient care. Liposarcoma (well-differentiated and dedifferentiated liposarcomas), leiomyosarcoma, and gastrointestinal stromal tumor are the 3 most common primary intra-abdominal sarcomas. In part 1 of this article, general features of soft tissue sarcomas and some of the common tumors from WHO category 1-4 found in abdomen and pelvis are discussed. Part 2 will focus on common tumors from remainder of the WHO categories.
软组织肉瘤是一组罕见的间叶恶性肿瘤,仅占所有成人实体恶性肿瘤的 1%。这些肿瘤在世界卫生组织(WHO)的最新分类中被分为 12 个广泛的组别。它们中的大多数缺乏特定的影像学特征,这对放射科医生来说是一个影像学难题。这些肿瘤通常在出现时就是大肿块,因为它们是无症状的或引起模糊的临床症状。这些肿瘤对外科医生来说也是一个挑战,因为它们很难实现完全切除,这是由于复杂的腹腔内解剖结构和它们与关键结构的密切关系。通常需要多学科方法来决定这些复杂病例的最佳管理方案,以提供最佳的患者护理。了解 WHO 分类、病理特征和可用的治疗选择将有助于放射科医生在多学科讨论这类病例和整体患者护理方面做出有意义的贡献。脂肪肉瘤(高分化和去分化脂肪肉瘤)、平滑肌肉瘤和胃肠道间质瘤是 3 种最常见的原发性腹腔内肉瘤。在本文的第 1 部分中,我们讨论了软组织肉瘤的一般特征以及在腹部和骨盆中发现的 WHO 分类 1-4 组中的一些常见肿瘤。第 2 部分将重点介绍其余 WHO 分类组中的常见肿瘤。