Department of Radiology, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK.
Department of Radiology, Royal National Orthopaedic Hospital, Stanmore, UK.
Br J Radiol. 2021 Jan 1;94(1117):20200790. doi: 10.1259/bjr.20200790. Epub 2020 Nov 11.
To determine the differential diagnosis of musculoskeletal soft tissue masses in children referred to a specialist musculoskeletal oncology unit.
All children (0-18 y) referred to a specialist musculoskeletal oncology unit over a 20-month period (September 2018-May 2020) were retrospectively reviewed. Demographic data and referral diagnoses were obtained from the electronic patient notes. MRI findings and histopathological results were recorded. The comparison of non-neoplastic, benign neoplastic and malignant diagnoses at the point of referral and final diagnosis was determined.
116 patients were included, 60 (51.7%) males and 56 (48.3%) females with mean age of 10.6 years (3 months-18 years). 69 (59.5%) patients were referred with a suspected sarcoma, 29 (25.0%) with a suspected benign tumour and 18 (15.5%) with a non-neoplastic lesion. A diagnosis was achieved by histological assessment in 61 (52.6%) cases, microbiological assessment in 3 (2.6%) or clinical and imaging assessment in 52 (44.8%). 67 (57.8%) cases had non-neoplastic pathology, 39 (33.6%) a benign tumour, 4 (3.4%) an intermediate-grade tumour, 6 (5.2%) a malignant tumour.
Although over half of children referred to a specialist musculoskeletal oncology unit were suspected of having a soft tissue sarcoma at referral, only 5.2% were diagnosed with a malignant tumour.
Approximately, 6 of 69 (8.7%) children referred to a specialist musculoskeletal oncology unit with a suspected soft tissue sarcoma will have a malignant lesion. Most paediatric soft tissue masses are non-neoplastic, the commonest diagnosis being a vascular malformation.
确定转诊至专业肌肉骨骼肿瘤学单位的儿童肌肉骨骼软组织肿块的鉴别诊断。
对 2018 年 9 月至 2020 年 5 月期间转诊至专业肌肉骨骼肿瘤学单位的所有儿童（0-18 岁）进行回顾性分析。从电子病历中获取人口统计学数据和转诊诊断。记录 MRI 结果和组织病理学结果。确定转诊时和最终诊断时非肿瘤性、良性肿瘤性和恶性诊断的比较。
共纳入 116 例患者，男 60 例（51.7%），女 56 例（48.3%），平均年龄 10.6 岁（3 个月-18 岁）。69 例（59.5%）患者因疑似肉瘤就诊，29 例（25.0%）因疑似良性肿瘤就诊，18 例（15.5%）因非肿瘤性病变就诊。61 例（52.6%）通过组织学评估、3 例（2.6%）通过微生物学评估或 52 例（44.8%）通过临床和影像学评估得出诊断。67 例（57.8%）为非肿瘤性病变，39 例（33.6%）为良性肿瘤，4 例（3.4%）为中等级别肿瘤，6 例（5.2%）为恶性肿瘤。
尽管转诊至专业肌肉骨骼肿瘤学单位的儿童中超过一半被怀疑患有软组织肉瘤，但只有 5.2%被诊断为恶性肿瘤。
大约 69 例（8.7%）转诊至专业肌肉骨骼肿瘤学单位的疑似软组织肉瘤儿童中有 6 例（8.7%）患有恶性病变。大多数儿科软组织肿块是非肿瘤性的，最常见的诊断是血管畸形。
