Sichuan Key Laboratory of Medical Imaging, and Department of Radiology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, Nanchong 637000, Sichuan, China.
Department of Pathology, Affiliated Hospital of North Sichuan Medical College, 63# Wenhua Road, Shunqing District, Nanchong 637000, Sichuan, China.
Curr Med Imaging. 2021;17(6):798-806. doi: 10.2174/1573405616666210104111946.
Epithelioid sarcoma (ES) is a rare histopathological type of soft tissue sarcoma. They are subcutaneous soft tissue masses that tend to arise in extremity sites (the classic type, formerly referred to as distal type) or proximal midline region of the body (the proximal type), such as the perineum, genital tract, and pelvis. The head and neck regions are rarely affected by ES, but the infratemporal fossa (ITF) is extremely rare. ES involving the ITF has not been reported before in literature. In this paper, the imaging features of ES were reviewed in detail, and the anatomical structure and epidemiology of ITF were briefly introduced.
We performed a systematic search from 3 databases, CNKI(China National Knowledge Internet), FMRS(Foreign Medical Literature Retrieval Service, Shenzhen METSTR Technology CO., Led. China), and PubMed, to obtain literature from January 1970 to July 2020. Epithelioid sarcoma, head and neck regions, infratemporal fossa, diagnostic imaging, anatomy, MRI, and CT were used as keywords for advanced retrieval. A study had to be found eligible for inclusion to be closely related to ES and/or ITF. A total of 129 related pieces of literature were retrieved successfully, of which 37 were closely related to this study. The case report in this article is from the Affiliated Hospital of North Sichuan Medical College. The present study was approved by the institutional review board of the Affiliated Hospital of North Sichuan Medical College and a written informed consent for the publication of the case was obtained from the patient.
A 33-year-old man accidentally found a slowly growing, painless mass in the left cheek more than a month ago. On plain computed tomography (CT) scan of the outpatient department, an oval slightly low-density mass with well-defined and uniform boundary in the infratemporal fossa was revealed, and on the contrast-enhanced scan, it was homogeneous and moderately enhanced. Initially, the CT appearance favored benign lesions. However, the possibility of a malignant tumor can not be excluded completely. Finally, the patient was referred to the inpatient department a tumor arose from IF and underwent a selective operation. The tumor was completely removed. Histologic findings were compatible with epithelioid sarcoma. Post-operatively, the patient received 2 cycles of radiotherapy, and there was no evidence of recurrence after 6 months follow- up.
The imaging manifestations of ES are various. The anatomic structure of ITF is complex and the pathological types are various. It should be very careful in the qualitative diagnosis of tumors from the ITF, and advanced imaging techniques will be useful in imaging diagnosis.
上皮样肉瘤（ES）是一种罕见的软组织肉瘤组织学类型。它们是皮下软组织肿块，倾向于发生在四肢部位（经典型，以前称为远端型）或身体的近端中线区域（近端型），如会阴、生殖道和骨盆。头颈部很少受 ES 影响，但颞下窝（ITF）极为罕见。以前文献中没有报道过累及 ITF 的 ES。本文详细回顾了 ES 的影像学特征，并简要介绍了 ITF 的解剖结构和流行病学。
我们从 3 个数据库，中国知网（CNKI）、国外医学文献检索服务系统（FMRS，深圳迈特思创科技有限公司）和 PubMed 进行了系统检索，以获取 1970 年 1 月至 2020 年 7 月的文献。上皮样肉瘤、头颈部、颞下窝、诊断影像学、解剖学、MRI 和 CT 被用作高级检索的关键字。只有与 ES 和/或 ITF 密切相关的研究才能被纳入。本文共成功检索到 129 篇相关文献，其中 37 篇与本研究密切相关。本文中的病例报告来自川北医学院附属医院。本研究得到了川北医学院附属医院伦理委员会的批准，并获得了患者同意出版病例的书面知情同意书。
一名 33 岁男性一个多月前偶然发现左脸颊处有一个缓慢生长、无痛的肿块。在门诊的平扫 CT 扫描中，发现颞下窝内有一个边界清楚、均匀的椭圆形稍低密度肿块，增强扫描时呈均匀性中度增强。起初，CT 表现倾向于良性病变。然而，不能完全排除恶性肿瘤的可能性。最后，患者被转至住院部，肿瘤起源于 IF，并进行了选择性手术。肿瘤被完全切除。组织学检查结果符合上皮样肉瘤。术后患者接受了 2 个周期的放疗，随访 6 个月后无复发迹象。
ES 的影像学表现多种多样。ITF 的解剖结构复杂，病理类型多样。在对来自 ITF 的肿瘤进行定性诊断时应非常小心，高级影像学技术将有助于影像学诊断。
